Related Experiment Videos
Penetration of piperacillin into the vitreous after intravenous administration
A Robinet1, M A Le Bot, J Colin
1Department of Ophthalmology, CHRU Morvan, Brest, France.
Purpose:
Penetration of piperacillin into the vitreous cavity after intravenous administration was investigated in humans.
Methods:
Forty-five eyes undergoing vitrectomy between November 1993 and December 1994 were included. Each patient received a single intravenous dose of piperacillin 4 g 2 hours before ocular incision. A 0.2-mL vitreous sample was aspired at the beginning of vitrectomy, a blood sample was obtained, and piperacillin level was assessed.
Results:
There were no detectable drug concentrations in 25 eyes. Mean vitreous drug concentration in the remaining evaluable eyes (n = 14) was 2.33 microg/mL (+/-0.76). We divided samples into two groups: 23 uninflamed (Group 1) and 16 inflamed (Group 2) eyes. Mean vitreous drug concentration was 0.42 microg/mL in Group 1 and 4.95 microg/mL in Group 2 (P < 0.2). Piperacillin concentration was higher than the minimum inhibitory concentration for gram-positive bacteria in 13% of uninflamed and 69% of inflamed eyes (P < 0.001).
Conclusion:
Studies show that intravenously administered piperacillin can penetrate the vitreous cavity in rabbits. Our study suggests that a single dose of piperacillin can produce intravitreal concentrations sufficient to kill gram-positive bacteria in inflamed eyes. The poor intraocular penetration of systemically administered piperacillin in uninflamed eyes raises questions about its usefulness as a prophylactic agent in ophthalmic surgery.
Insights
Intravenous piperacillin achieved therapeutic vitreous levels in inflamed eyes but not in uninflamed eyes. This suggests limited utility as a prophylactic agent in ophthalmic surgery for uninflamed conditions.
Area of Science:
- Ophthalmology
- Pharmacology
- Infectious Diseases
Background:
- Intravenous piperacillin is used for bacterial infections.
- Understanding its penetration into the eye is crucial for treating ocular infections and for surgical prophylaxis.
Purpose of the Study:
- To investigate the penetration of piperacillin into the human vitreous cavity after intravenous administration.
- To determine if piperacillin concentrations reach levels effective against common ocular pathogens.
Main Methods:
- A single intravenous dose of 4 g piperacillin was administered to 45 patients prior to vitrectomy.
- Vitreous and blood samples were collected to measure piperacillin concentrations.
- Eyes were categorized as inflamed or uninflamed.
Main Results:
- Piperacillin was detected in the vitreous of 14 out of 45 eyes.
- Mean vitreous concentration was 2.33 microg/mL.
- Concentrations were significantly higher in inflamed eyes (4.95 microg/mL) compared to uninflamed eyes (0.42 microg/mL).
- Therapeutic concentrations against gram-positive bacteria were achieved in 69% of inflamed eyes versus 13% of uninflamed eyes.
Conclusions:
- Intravenously administered piperacillin can achieve therapeutic concentrations in the vitreous of inflamed eyes.
- Poor penetration into uninflamed eyes raises concerns about its prophylactic use in ophthalmic surgery.
- Further research may be needed to optimize dosing or explore alternative agents for prophylaxis in uninflamed eyes.