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Intracameral moxifloxacin: in vitro safety on human ocular cells
Marcus Kernt1, Aljoscha S Neubauer, Raffael G Liegl
1Department of Ophthalmology, Ludwig-Maximilians-Universität, Munich, Germany. marcus.kernt@med.uni-muenchen.de
Purpose:
The fourth-generation fluoroquinolone, moxifloxacin, covers most gram-positive and gram-negative isolates causing endophthalmitis. It is safe and effective for systemic and topical use, but only limited data are available on prophylactic intracameral administration to prevent endophthalmitis. This study uses a cell culture model to investigate the safety of moxifloxacin for intracameral application.
Methods:
Endothelial toxicity of moxifloxacin was evaluated in cultured human corneas. Possible toxic effects of moxifloxacin (10-750 microg/mL) in corneal endothelial cells (CEC), primary human trabecular meshwork cells (TMC), and primary human retinal pigment epithelial (RPE) cells were evaluated after 24 hours and under conditions of oxidative and inflammatory stress by treatment with tumor necrosis factor alpha, lipopolysaccharides, or interleukin-6. Toxicity was evaluated by tetrazolium dye reduction assay, and cell viability was quantified by a microscopic live-dead assay.
Results:
No corneal endothelial toxicity could be detected after 30 days of treatment with 500 microg/mL moxifloxacin. Concentrations up to 150 microg/mL had no influence on CEC, TMC, or RPE cell proliferation or on cell viability when administered for 24 hours. After preincubation with tumor necrosis factor alpha, lipopolysaccharides, or interleukin-6 for 24 hours and subsequent treatment with moxifloxacin at concentrations from 10 to 150 microg/mL for 24 hours, no significant decrease in proliferation or viability was observed. Hydrogen peroxide exposure did not increase cellular toxicity.
Conclusions:
This study showed no significant toxicity for moxifloxacin on CEC, TMC, RPE cells, or human corneal endothelium for concentrations up to 150 microg/mL. The minimum inhibitory concentration of moxifloxacin to inhibit 90% of pathogens commonly encountered in endophthalmitis is known to be in the range of 0.25-2.5 microg/mL. Therefore, prophylactic intracameral use of moxifloxacin at concentrations up to 150 microg/mL may be safely used to prevent endophthalmitis after intraocular surgery.
Insights
Moxifloxacin demonstrates no significant toxicity to ocular cells at concentrations up to 150 microg/mL. This finding supports the safe prophylactic intracameral use of moxifloxacin to prevent endophthalmitis after intraocular surgery.
Area of Science:
- Ophthalmology
- Microbiology
- Cell Biology
Background:
- Endophthalmitis is a severe intraocular infection often caused by gram-positive and gram-negative bacteria.
- Moxifloxacin, a fourth-generation fluoroquinolone, exhibits broad-spectrum activity against common endophthalmitis pathogens.
- While effective systemically and topically, data on prophylactic intracameral moxifloxacin are limited.
Purpose of the Study:
- To investigate the safety of intracameral moxifloxacin administration.
- To evaluate potential toxicity of moxifloxacin on key ocular cells using a cell culture model.
Main Methods:
- Human corneal endothelial cells (CEC), trabecular meshwork cells (TMC), and retinal pigment epithelial (RPE) cells were cultured.
- Cells were exposed to moxifloxacin (10-750 microg/mL) for 24 hours and 30 days.
- Toxicity was assessed under basal, oxidative, and inflammatory stress conditions using cell viability and proliferation assays.
Main Results:
- No corneal endothelial toxicity was observed with moxifloxacin up to 500 microg/mL after 30 days.
- Moxifloxacin concentrations up to 150 microg/mL did not affect CEC, TMC, or RPE cell viability or proliferation after 24 hours.
- Neither oxidative stress (hydrogen peroxide) nor inflammatory stimuli (TNF-α, LPS, IL-6) increased moxifloxacin-induced cellular toxicity.
Conclusions:
- Moxifloxacin exhibits no significant toxicity to human corneal endothelium, CEC, TMC, or RPE cells at concentrations up to 150 microg/mL.
- The minimum inhibitory concentration for common endophthalmitis pathogens is 0.25-2.5 microg/mL.
- Prophylactic intracameral use of moxifloxacin at concentrations up to 150 microg/mL is considered safe for preventing endophthalmitis post-intraocular surgery.
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