PURPOSE: To study intravitreal dexamethasone and vancomycin concentrations, when used together in patients with suspected postoperative bacterial endophthalmitis. Animal studies had suggested that dexamethasone might decrease the concentration of vancomycin.
DESIGN: Prospective randomized clinical trial in a tertiary referral center.
METHODS: Twenty-nine consecutive patients with suspected postoperative bacterial endophthalmitis underwent a vitreous biopsy followed by intravitreal injection of antibiotics (0.2 mg vancomycin, 0.05 mg gentamicin) and 400 mug dexamethasone or placebo. After 3-4 days, the intravitreal injection of antibiotics and dexamethasone or placebo was repeated. In 18 patients, a second biopsy was taken for repeat culture and measurement of vancomycin and dexamethasone concentrations.
RESULTS: In 20/29 patients (69%) the first vitreous cultures were positive; the second culture was negative in all cases. Thirteen out of 29 patients received dexamethasone. Dexamethasone concentrations showed an average of 25 ng/ml 3 days after injection, with an estimated half-life of 5.5 h. Vancomycin concentrations in patients given dexamethasone tended to be higher compared with those in the placebo group (P=0.061).
CONCLUSION: Intravitreal dexamethasone does not lead to decreased vancomycin concentrations, when given simultaneously in the treatment of patients with suspected bacterial endophthalmitis.
|Number of pages||4|
|Journal||Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie|
|Publication status||Published - Nov 2005|
- Aged, 80 and over
- Anti-Bacterial Agents/pharmacokinetics
- Biological Availability
- Endophthalmitis/drug therapy
- Eye Infections, Bacterial/drug therapy
- Middle Aged
- Postoperative Complications
- Prospective Studies
- Vitreous Body/metabolism