Treatment of experimental methicillin-resistant Staphylococcus epidermidis endophthalmitis with intravitreal vancomycin

Ophthalmology. 1986 Oct;93(10):1328-35. doi: 10.1016/s0161-6420(86)33579-6.

Abstract

Endophthalmitis remains a dreaded complication of intraocular surgery and penetrating eye trauma. Subconjunctival, topical, and systemic antibiotics have been largely ineffective in the treatment of endophthalmitis, whereas intravitreal antibiotics have proved efficacious. Methicillin-resistant Staphylococcus epidermidis has become an important pathogen in many infections, including endophthalmitis. Toxicity, clearance, and efficacy of intravitreal vancomycin were evaluated in the treatment of experimental methicillin-resistant S. epidermidis endophthalmitis. No evidence of retinal toxicity was found and therapeutic levels were demonstrated six days after injection. The treated rabbit eyes showed a marked beneficial effect when compared to the untreated eyes. If experience confirms the safety of intravitreal vancomycin in human eyes, vancomycin should be considered the drug of choice for methicillin-resistant S. epidermidis endophthalmitis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Drug Evaluation
  • Endophthalmitis / drug therapy
  • Endophthalmitis / etiology*
  • Endophthalmitis / pathology
  • Humans
  • Injections
  • Methicillin / therapeutic use*
  • Microscopy, Electron
  • Penicillin Resistance
  • Rabbits
  • Staphylococcal Infections* / drug therapy
  • Staphylococcus epidermidis
  • Vancomycin / administration & dosage*
  • Vancomycin / metabolism
  • Vancomycin / therapeutic use
  • Vitreous Body

Substances

  • Vancomycin
  • Methicillin