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. 1995 Jun;79(6):606–609. doi: 10.1136/bjo.79.6.606

Topical 0.3% ciprofloxacin, norfloxacin, and ofloxacin in treatment of bacterial keratitis: a new method for comparative evaluation of ocular drug penetration.

J P Diamond 1, L White 1, J P Leeming 1, H Bing Hoh 1, D L Easty 1
PMCID: PMC505175  PMID: 7626579

Abstract

AIMS--This study was designed to assess the relative corneal penetration of topical drops of three antibiotics and to relate those levels to minimum inhibitory concentrations for organisms associated with bacterial keratitis. METHODS--Four drops of each of ciprofloxacin, norfloxacin, and ofloxacin (0.3% topical ophthalmic preparations) were given to 12 patients undergoing corneal transplantation. After the recipient tissue was removed, corneal drug penetration was measured using high performance liquid chromatography. RESULTS--Intracorneal concentrations of ofloxacin (geometric mean 0.81 mg kg-1) were significantly higher than both ciprofloxacin (0.60 mg kg-1; p = 0.048) and norfloxacin (0.54 mg kg-1; p = 0.012). Ciprofloxacin and norfloxacin concentrations did not differ significantly (p = 0.33). CONCLUSIONS--Review of the minimum inhibitory concentrations of the fluoroquinolones against ocular pathogens reveals that ciprofloxacin is more potent than ofloxacin against many bacteria; ofloxacin is in turn more potent than norfloxacin. These data favour the selection of ciprofloxacin and ofloxacin rather than norfloxacin for the empirical treatment of corneal infection. The greater potency of ciprofloxacin offsets the superior penetration of ofloxacin. There is a need for improved clinical trial data concerning the use of fluoroquinolone eyedrops in ulcerative keratitis; some encouraging data are available for ciprofloxacin but not (in humans) for norfloxacin or ofloxacin.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barry A. L., Jones R. N. In-vitro activities of temafloxacin, tosufloxacin (A-61827) and five other fluoroquinolone agents. J Antimicrob Chemother. 1989 Apr;23(4):527–535. doi: 10.1093/jac/23.4.527. [DOI] [PubMed] [Google Scholar]
  2. Chin N. X., Novelli A., Neu H. C. In vitro activity of lomefloxacin (SC-47111; NY-198), a difluoroquinolone 3-carboxylic acid, compared with those of other quinolones. Antimicrob Agents Chemother. 1988 May;32(5):656–662. doi: 10.1128/aac.32.5.656. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cutarelli P. E., Lass J. H., Lazarus H. M., Putman S. C., Jacobs M. R. Topical fluoroquinolones: antimicrobial activity and in vitro corneal epithelial toxicity. Curr Eye Res. 1991 Jun;10(6):557–563. doi: 10.3109/02713689109001764. [DOI] [PubMed] [Google Scholar]
  4. Donnenfeld E. D., Schrier A., Perry H. D., Aulicino T., Gombert M. E., Snyder R. Penetration of topically applied ciprofloxacin, norfloxacin, and ofloxacin into the aqueous humor. Ophthalmology. 1994 May;101(5):902–905. doi: 10.1016/s0161-6420(13)31248-2. [DOI] [PubMed] [Google Scholar]
  5. Gritz D. C., McDonnell P. J., Lee T. Y., Tang-Liu D., Hubbard B. B., Gwon A. Topical ofloxacin in the treatment of Pseudomonas keratitis in a rabbit model. Cornea. 1992 Mar;11(2):143–147. doi: 10.1097/00003226-199203000-00008. [DOI] [PubMed] [Google Scholar]
  6. Grüneberg R. N., Felmingham D., O'Hare M. D., Robbins M. J., Perry K., Wall R. A., Ridgway G. L. The comparative in-vitro activity of ofloxacin. J Antimicrob Chemother. 1988 Sep;22 (Suppl 100):9–19. doi: 10.1093/jac/22.supplement_c.9. [DOI] [PubMed] [Google Scholar]
  7. Koidou-Tsiligianni A., Alfonso E., Forster R. K. Ulcerative keratitis associated with contact lens wear. Am J Ophthalmol. 1989 Jul 15;108(1):64–67. doi: 10.1016/s0002-9394(14)73262-3. [DOI] [PubMed] [Google Scholar]
  8. Leibowitz H. M. Clinical evaluation of ciprofloxacin 0.3% ophthalmic solution for treatment of bacterial keratitis. Am J Ophthalmol. 1991 Oct;112(4 Suppl):34S–47S. [PubMed] [Google Scholar]
  9. McDermott M. L., Tran T. D., Cowden J. W., Buggé C. J. Corneal stromal penetration of topical ciprofloxacin in humans. Ophthalmology. 1993 Feb;100(2):197–200. doi: 10.1016/s0161-6420(13)31672-8. [DOI] [PubMed] [Google Scholar]
  10. Neu H. C. Microbiologic aspects of fluoroquinolones. Am J Ophthalmol. 1991 Oct;112(4 Suppl):15S–24S. [PubMed] [Google Scholar]
  11. Osato M. S., Jensen H. G., Trousdale M. D., Bosso J. A., Borrmann L. R., Frank J., Akers P. The comparative in vitro activity of ofloxacin and selected ophthalmic antimicrobial agents against ocular bacterial isolates. Am J Ophthalmol. 1989 Oct 15;108(4):380–386. doi: 10.1016/s0002-9394(14)73305-7. [DOI] [PubMed] [Google Scholar]
  12. Parks D. J., Abrams D. A., Sarfarazi F. A., Katz H. R. Comparison of topical ciprofloxacin to conventional antibiotic therapy in the treatment of ulcerative keratitis. Am J Ophthalmol. 1993 Apr 15;115(4):471–477. doi: 10.1016/s0002-9394(14)74449-6. [DOI] [PubMed] [Google Scholar]

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