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Antibiotic-impregnated fibrin glue in ocular surgery: in vitro antibacterial activity
1Laboratori Sperimentali di Ricerca, IRCCS S. Matteo, Università di Pavia, Italia.
Abstract:
A strategy to reduce postoperative ocular infections might consist in maintaining a high antibiotic concentration in the eye by using a topical slow-release drug formulation. Fibrin glue is widely used in ocular surgery. Vancomycin, teicoplanin, cephalothin and gentamicin were added to a 500 IU/ml thrombin solution, their concentrations in 1 g fibrin glue being 500 microg for vancomycin and 400 microg for the other drugs. The in vitro antibacterial activity of antibiotic-impregnated fibrin glue was evaluated against a recent clinical isolate of Staphylococcus epidermidis. Moreover the antibiotic elution from fibrin discs in saline was assayed for up to 96 h. Fibrin glue properties were maintained when thrombin was reconstituted with a CaCl2 solution additioned with the antibiotics tested. All antibiotic fibrin mixtures exhibited good antistaphylococcal activity immediately after the preparation. A prolonged inhibition (4 days) of S. epidermidis growth was observed with teicoplanin discs. Gentamicin and teicoplanin levels were higher than those of the other antibiotics. The results suggest that the fibrin glycopeptide and/or gentamicin mixtures can be used, both prophylactically and therapeutically, in ocular surgery.
Insights
This study explored antibiotic-loaded fibrin glue for preventing eye infections after surgery. Teicoplanin and gentamicin-loaded fibrin glue showed prolonged antibacterial activity against Staphylococcus epidermidis.
Area of Science:
- Ophthalmology
- Microbiology
- Biomaterials Science
Background:
- Postoperative ocular infections pose a significant risk in ophthalmic surgery.
- Maintaining high antibiotic concentrations in the eye is crucial for infection prevention.
- Topical slow-release drug formulations offer a potential strategy to achieve sustained therapeutic levels.
Purpose of the Study:
- To evaluate the efficacy of antibiotic-impregnated fibrin glue as a slow-release drug delivery system for preventing ocular infections.
- To assess the in vitro antibacterial activity and elution profile of vancomycin, teicoplanin, cephalothin, and gentamicin incorporated into fibrin glue.
Main Methods:
- Antibiotics (vancomycin, teicoplanin, cephalothin, gentamicin) were incorporated into fibrin glue at specified concentrations.
- The in vitro antibacterial activity of the antibiotic-impregnated fibrin glue was tested against Staphylococcus epidermidis.
- Antibiotic elution from fibrin discs was measured in saline over 96 hours.
- Fibrin glue properties were assessed after antibiotic incorporation.
Main Results:
- Fibrin glue properties remained intact after antibiotic addition.
- All antibiotic-fibrin mixtures demonstrated immediate antistaphylococcal activity.
- Teicoplanin-impregnated fibrin glue provided prolonged inhibition of Staphylococcus epidermidis growth for up to 4 days.
- Elution studies indicated higher sustained levels for gentamicin and teicoplanin compared to other antibiotics.
Conclusions:
- Antibiotic-loaded fibrin glue, particularly with teicoplanin and gentamicin, is a promising formulation for sustained drug release in ocular surgery.
- This approach can be utilized both prophylactically and therapeutically to reduce the incidence of postoperative ocular infections.
- Further research may explore clinical applications of these antibiotic-eluting biomaterials in ophthalmology.