Human aqueous humor levels of oral ciprofloxacin, levofloxacin, and moxifloxacin

Abstract

Purpose: To evaluate the penetration of ciprofloxacin, levofloxacin, and moxifloxacin into the aqueous humor after oral administration. Setting: Alcorcon Hospital, Madrid, Spain. Methods: Forty-two patients having cataract surgery were randomly divided into 3 groups the day before surgery. The first group received 2 oral 500 mg doses of ciprofloxacin at 12-hour intervals. The second group received a single oral 500 mg dose of levofloxacin. The third group received a single oral 400 mg dose of moxifloxacin. At the time of surgery, 0.1 mL aqueous fluid was aspirated from the anterior chamber just before the operation and immediately stored at −80°C. Drug concentrations were measured using a biological assay. Results: The mean aqueous level of ciprofloxacin was 0.50 μg/mL ± 0.25 (SD); of levofloxacin, 1.50 ± 0.50 μg/mL; and of moxifloxacin, 2.33 ± 0.85 μg/mL. The mean aqueous levels of levofloxacin and moxifloxacin were above the 90% minimum inhibitory concentration for most of the common microorganisms that cause endophthalmitis. Conclusions: Therapeutic concentrations of fluoroquinolones, mainly levofloxacin and moxifloxacin, were reached with oral administration. These antibiotics may be effective for prophylaxis and adjuvant therapy of bacterial endophthalmitis.