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In vitro and in vivo studies with sodium hyaluronate as a carrier for intraocular gentamicin
C A Moreira1, A T Moreira, D K Armstrong
1Department of Ophthalmology, Doheny Eye Institute, Los Angeles, CA.
Abstract:
We compared the in vitro growth of common intraocular pathogens Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa in rabbit vitreous and in sodium hyaluronate (SH) with and without gentamicin. The minimal inhibitory concentration for gentamicin/SH was 0.5, 0.062 and 2.0 mcg/ml for these pathogens, respectively. After posterior capsulotomy, P. aeruginosa was inoculated into the anterior vitreous and all 15 untreated eyes developed endophthalmitis. In a similar group, aqueous gentamicin administered in the anterior chamber reduced the incidence of endophthalmitis to 10 of 15 eyes. Under similar circumstances, the SH/gentamicin combination lowered the incidence of endophthalmitis significantly to 4 of 15 eyes. The half-life of aqueous gentamicin was 0.9 h, which was shorter than the 2.2 h for SH/gentamicin combination. These results suggest that SH may be a useful carrier for intraocular drug therapy.
Insights
Sodium hyaluronate (SH) combined with gentamicin shows promise as an intraocular drug delivery system. This combination significantly reduced endophthalmitis incidence and prolonged drug half-life compared to aqueous gentamicin alone.
Area of Science:
- Ophthalmology
- Microbiology
- Pharmacology
Background:
- Endophthalmitis remains a significant risk following intraocular surgery.
- Effective intraocular antibiotic delivery is crucial for preventing and treating post-operative infections.
Purpose of the Study:
- To evaluate sodium hyaluronate (SH) as a carrier for gentamicin in treating intraocular infections.
- To compare the efficacy of gentamicin/SH with aqueous gentamicin in a rabbit model of Pseudomonas aeruginosa endophthalmitis.
Main Methods:
- In vitro determination of minimal inhibitory concentrations (MICs) of gentamicin/SH against Staphylococcus aureus, S. epidermidis, and P. aeruginosa.
- Induction of endophthalmitis in rabbit eyes via P. aeruginosa inoculation after posterior capsulotomy.
- Comparison of untreated eyes, eyes treated with aqueous gentamicin, and eyes treated with SH/gentamicin combination.
Main Results:
- Gentamicin/SH demonstrated effective in vitro inhibition of pathogens.
- SH/gentamicin significantly reduced endophthalmitis incidence (4/15 eyes) compared to aqueous gentamicin (10/15 eyes) and untreated controls (15/15 eyes).
- The half-life of gentamicin was extended when formulated with SH (2.2 h) compared to aqueous administration (0.9 h).
Conclusions:
- Sodium hyaluronate serves as an effective carrier for intraocular gentamicin delivery.
- The SH/gentamicin combination offers improved therapeutic potential for managing intraocular infections.
- Further investigation into SH as a drug delivery vehicle for ophthalmic applications is warranted.