Cornea

Skip Navigation LinksHome > October 2013 - Volume 32 - Issue 10 > Vitreous and Aqueous Penetration of Orally Administered Trim...
Cornea:
doi: 10.1097/ICO.0b013e318298ddf8
Clinical Science

Vitreous and Aqueous Penetration of Orally Administered Trimethoprim-Sulfamethoxazole Combination in Humans

Feiz, Vahid MD*; Nijm, Lisa MD, JD*; Glickman, Randolph D. PhD; Morse, Lawrence S. MD, PhD*; Telander, David G. MD, PhD*; Park, Susanna S. MD, PhD*; Polage, Christopher R. MD; Christiansen, Steven M. MD§; Moshirfar, Majid MD§

Collapse Box

Abstract

Purpose: To determine the penetration of orally administered trimethoprim (TMP)-sulfamethoxazole (SMX) into the aqueous and vitreous cavity of noninflamed human eyes.

Methods: Nine adult patients undergoing cataract surgery and 10 adult patients undergoing pars plana vitrectomy were given 3 doses of oral TMP-SMX every 12 hours before the surgery. Aqueous and blood samples were collected from patients undergoing cataract surgery; vitreous and blood samples were collected from patients undergoing vitrectomy. The levels of TMP and SMX were analyzed using high-performance liquid chromatography and were compared with the mean minimum inhibitory concentrations (MIC90) of potential ocular pathogens.

Results: TMP-SMX was present in all samples. Among eyes undergoing cataract surgery, the mean concentrations of TMP in aqueous and blood were 0.341 ± 0.141 μg/mL (mean ± SD) and 1.501 ± 0.433 μg/mL and of SMX were 5.259 ± 0.929 μg/mL and 11.835 ± 2.100 μg/mL, respectively. Among eyes undergoing vitrectomy, the mean concentrations of TMP in vitreous and blood were 1.864 ± 0.807 μg/mL and 4.591 ± 2.979 μg/mL and of SMX were 5.910 ± 2.705 μg/mL and 39.289 ± 15.469 μg/mL, respectively. MIC90 levels were achieved against many bacterial pathogens, including methicillin-resistant Staphylococcus aureus.

Conclusions: TMP-SMX penetrates both the aqueous and vitreous cavities when given orally. The components reach therapeutic inhibitory concentrations in the ocular cavity against many potential pathogens.

© 2013 by Lippincott Williams & Wilkins.

Login

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.