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Cefonicid concentrations in human aqueous humor
Archives of Ophthalmology (Chicago, Ill. : 1960)
|March 1, 1984
Summary
Cefonicid sodium, given before cataract surgery, reached low levels in eye fluid despite high serum concentrations. This may be due to high protein binding, potentially limiting its effectiveness against common eye infections.
Area of Science:
- Ophthalmology
- Pharmacology
- Infectious Diseases
Background:
- Cataract surgery poses a risk of postoperative bacterial endophthalmitis.
- Antibiotic prophylaxis is crucial to prevent such infections.
- Understanding antibiotic penetration into ocular tissues is vital for effective prophylaxis.
Purpose of the Study:
- To evaluate the penetration of cefonicid sodium into the aqueous humor following intravenous administration prior to cataract surgery.
- To determine if cefonicid concentrations in the aqueous humor achieve levels sufficient to inhibit common pathogens causing endophthalmitis.
Main Methods:
- Intravenous administration of one-gram doses of cefonicid sodium to patients undergoing cataract surgery.
- Measurement of cefonicid concentrations in serum and aqueous humor at specified time points post-administration.
- Analysis of cefonicid protein binding and comparison of achieved concentrations with minimum inhibitory concentrations (MICs) of relevant bacteria.
Main Results:
- High serum concentrations of cefonicid sodium were observed after intravenous administration.
- Low mean peak concentrations of cefonicid (0.25 and 0.27 mg/L at 2 and 4 hours, respectively) were detected in the aqueous humor.
- The high protein binding of cefonicid was identified as a potential factor for the limited ocular penetration.
Conclusions:
- Intravenous cefonicid sodium demonstrates poor penetration into the aqueous humor in patients undergoing cataract surgery.
- The achieved cefonicid concentrations in the aqueous humor were below the minimum inhibitory concentrations for common pathogens implicated in bacterial endophthalmitis.
- Cefonicid sodium's high protein binding may significantly impede its efficacy as a prophylactic agent for bacterial endophthalmitis in this context.