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Evaluation of dropless prophylaxis with Tri-Moxi-Vanc and Tri-Moxi for preventing endophthalmitis in a rabbit model

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Session Details

Session Title: Presented Poster Session: Miscellaneous and Infections

Venue: Poster Village: Pod 3

First Author: : R.Kowalski USA

Co Author(s): :    E. Romanowski   R. Shanks   A. Mammen   D. Dhaliwal     

Abstract Details

Purpose:

The use of intravitreal injections of antibiotics and anti-inflammatories to replace topical drops has gained interest for surgical prophylaxis. We tested the efficacy of intravitreal TRI-MOXI-VANC (triamcinolone-moxifloxacin-vancomycin) and TRI-MOXI for preventing Staphylococcus aureus (SA) endophthalmitis in rabbits.

Setting:

The Charles T. Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh, Pittsburgh, PA, USA

Methods:

Formulations of TRI-MOXI-VANC (15/1/10 mg/ml) and TRI-MOXI (15/1 mg/ml) were provided by Imprimis Pharmaceuticals. Seven groups of 8 rabbits each (A-G) were tested with intravitreal injections of medication or control. The vitreous was challenged with SA isolates (5000 CFU) with varying MICs to moxifloxacin (in µg/ml and denoted by the value at the end of each group listed): A) TRI-MOXI-VANC-10, B) TRI-MOXI-10, C) Saline-10, D) TRI-MOXI-2, E) Saline-2, F) TRI-MOX-0.032, and G) Saline-0.032. After 24 hours, the rabbit eyes were graded for clinical endophthalmitis, and cultured for viable SA.

Results:

Rabbits treated with TRI-MOXI-VANC and challenged with a SA moxifloxacin MIC of 10 μg/ml did not present with endophthalmitis (0/8, no eyes with endophthalmitis). For SA moxifloxacin with MICs of 10.0 and 2.0 μg/ml, TRI-MOXI without VANC did not prevent endophthalmitis (16/16, 100% of eyes with endophthalmitis). For a SA moxifloxacin MIC of 0.032 μg/ml, endophthalmitis was prevented with TRI-MOXI without VANC (0/8, no eyes with endophthalmitis). All saline treated eyes developed endophthalmitis (23/23, 100% of eyes with endophthalmitis).

Conclusions:

Our data indicates that intravitreal TRI-MOXI-VANC was able to prevent endophthalmitis by SA with an elevated MIC to moxifloxacin whereas TRI-MOX without VANC did not provide consistent protection to prevent SA endophthalmitis.

Financial Disclosure:

NONE

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