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Intravitreal daptomycin: a safety and efficacy study.

Grant M Comer1, John B Miller, Eric W Schneider

  • 1Retina Service, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan 48105, USA.

Retina (Philadelphia, Pa.)
|April 28, 2011
PubMed
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Intravitreal daptomycin at 200 μg is safe and effective for bacterial endophthalmitis in rabbits. This antibiotic shows promise for treating infections caused by vancomycin-resistant organisms.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Pharmacology

Background:

  • Vancomycin-resistant organisms pose a significant challenge in treating bacterial endophthalmitis.
  • Daptomycin is a lipopeptide antibiotic effective against Gram-positive bacteria, including resistant strains.

Purpose of the Study:

  • To evaluate the ocular toxicity of intravitreal daptomycin.
  • To assess the efficacy of intravitreal daptomycin in treating experimental bacterial endophthalmitis caused by Staphylococcus epidermidis.

Main Methods:

  • Dutch belted rabbits received varying doses of intravitreal daptomycin (75-750 μg) to assess toxicity via clinical examination, electroretinography, and histology.
  • Experimental endophthalmitis was induced, and the efficacy of 200 μg intravitreal daptomycin was measured by vitreous bacterial cultures at 24 and 48 hours.

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Intravitreal Injection and Quantitation of Infection Parameters in a Mouse Model of Bacterial Endophthalmitis
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Intravitreal Injection and Quantitation of Infection Parameters in a Mouse Model of Bacterial Endophthalmitis

Published on: February 6, 2021

Main Results:

  • Doses of 75 μg and 188 μg of intravitreal daptomycin showed acceptable safety profiles.
  • Higher doses led to dose-dependent cataract formation, electroretinogram suppression, and photoreceptor damage.
  • 200 μg of intravitreal daptomycin achieved near-complete vitreous sterilization within 24 hours, and complete sterilization by 48 hours.

Conclusions:

  • Intravitreal daptomycin at a 200 μg dose is safe and effective in a rabbit model of bacterial endophthalmitis.
  • Daptomycin warrants further investigation as a treatment for intraocular infections, particularly those caused by vancomycin-resistant bacteria.