Intravitreal Vancomycin
- 1 June 1987
- journal article
- research article
- Published by American Medical Association (AMA) in American Journal of Ophthalmology
- Vol. 105 (6), 831-837
- https://doi.org/10.1001/archopht.1987.01060060117045
Abstract
• Some of the gram-positive isolates from exogenous bacterial endophthalmitis cases treated at our institution have been found to be resistant to either cefazolin sodium, gentamicin sulfate, or both. However, all of these isolates have been sensitive to vancomycin. These findings prompted us to reevaluate the retinal toxicity and clearance of intravitreal vancomycin in pigmented rabbits. Doses up to 2 mg were found to be nontoxic in phakic and aphakic-vitrectomized eyes. Clearance was determined in phakic and aphakic-vitrectomized rabbit eyes with or without intact lens capsules. The antibiotic was cleared most slowly in phakic eyes. Aphakic-vitrectomized eyes without an intact lens capsule cleared antibiotic most rapidly, while aphakic-vitrectomized eyes with intact capsules exhibited an intermediate clearance rate. In addition, the interaction between vancomycin and gentamicin on gram-positive endophthalmitis isolates was found to be additive or synergistic depending on the bacterial species. Based on these data, we recommend the combination of vancomycin and an aminoglycoside as the initial antibiotic therapy for exogenous bacterial endophthalmitis.Keywords
This publication has 10 references indexed in Scilit:
- The vitreousEye, 1992
- A prospective study of adverse reactions associated with vancomycin therapyJournal of Antimicrobial Chemotherapy, 1985
- Vancomycin/aminoglycoside nephrotoxicityThe Journal of Pediatrics, 1985
- Nephrotoxicity associated with vancomycin-aminoglycoside therapy in four childrenThe Journal of Pediatrics, 1984
- Retrospective study of the toxicity of preparations of vancomycin from 1974 to 1981Antimicrobial Agents and Chemotherapy, 1983
- Drug-induced OtotoxicityDrugs, 1980
- Prevention and Management of Traumatic EndophthalmitisOphthalmology, 1980
- The Nephrotoxicity of Antimicrobial AgentsNew England Journal of Medicine, 1977
- Experimental Intravitreal GentamicinAmerican Journal of Ophthalmology, 1976
- Intraocular Penetration of VancomycinAmerican Journal of Ophthalmology, 1962