Patients with open globe injuries routinely receive fluoroquinolone prophylaxis to prevent infectious endophthalmitis. However, there’s a dearth of clinical trials evaluating optimal prophylactic dosing, given the rarity of this infection.
To address this knowledge gap, researchers did a risk assessment study to identify the antibiotic dosing options that optimize prophylactic treatment success against common bacterial pathogens implicated in post-traumatic endophthalmitis. They found that moxifloxacin 400mg PO daily had the highest likelihood of prophylactic success in the prevention of endophthalmitis post-trauma and was superior to the ciprofloxacin and levofloxacin dosing options currently endorsed by expert opinion.
The team used data from published studies to evaluate five fluoroquinolone dosing options to determine which performed best. Moxifloxacin 400mg PO daily led the pack with a 72% probability of achieving the target dose, followed by levofloxacin (between 54% and 63%) and ciprofloxacin (between 28% and 35%).
|Peragine C, Walker SAN, Walker S, et al. Fluoroquinolone antibiotic prophylaxis to prevent post-traumatic bacterial infectious endophthalmitis: using Monte Carlo simulation to evaluate the probability of success. J Ocul Pharm Thera. May 8, 2019. [Epub ahead of print]. 1.|