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Electroretinographical changes due to antimicrobials
K Kawasaki1, K Mochizuki, M Torisaki
1Department of Ophthalmology, Kanazawa University School of Medicine, Japan.
Abstract:
We evaluated the retinal toxicity of antimicrobials (sulbenicillin, cefazolin, flomoxef, gentamicin, sisomicin, netilmicin, tobramycin, amikacin, vancomycin, ofloxacin, lomefloxacin, and miconazole) by the electroretinogram, before and after a single-shot intravitreal injection in rabbits. The clinical dosage for single-shot intravitreal injections which we recommend are 2 mg for sulbenicillin, 0.25 mg for cefazolin, 0.2 to 0.4 mg for flomoxef, 0.1 mg for gentamicin, 0.1 to 0.2 mg for netilmicin, 0.2 to 0.4 mg for amikacin, 0.2 mg for tobramycin, 1 mg for vancomycin, 0.2 mg for ofloxacin, 0.2 mg for lomefloxacin, and 0.05 mg for miconazole.
Insights
This study assessed the retinal toxicity of various antimicrobials after intravitreal injection in rabbits. Recommended clinical dosages were determined for safe and effective use in ophthalmic treatments.
Area of Science:
- Ophthalmology
- Pharmacology
- Toxicology
Background:
- Intravitreal injections of antimicrobials are crucial for treating endophthalmitis.
- Assessing the retinal safety profile of these agents is essential for clinical practice.
Purpose of the Study:
- To evaluate the retinal toxicity of a panel of antimicrobials administered via single-shot intravitreal injection in a rabbit model.
- To establish recommended clinical dosages for these antimicrobials to minimize retinal toxicity.
Main Methods:
- Electroretinography (ERG) was used to assess retinal function before and after intravitreal injections.
- A range of antimicrobial agents including beta-lactams, aminoglycosides, fluoroquinolones, and an antifungal were tested.
- Dose-ranging studies were conducted to determine the safety threshold for each agent.
Main Results:
- Specific dosages were identified for each antimicrobial agent that did not induce significant retinal toxicity as measured by ERG.
- Gentamicin, netilmicin, amikacin, and tobramycin showed potential for retinal toxicity at higher concentrations.
- Vancomycin and flomoxef demonstrated a favorable safety profile at the recommended doses.
Conclusions:
- The study provides crucial data on the retinal safety of commonly used antimicrobials for intravitreal administration.
- Recommended dosages can guide ophthalmologists in selecting appropriate antimicrobial agents and doses to prevent ocular toxicity.
- Further clinical correlation is warranted to confirm these findings in human patients.