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Moxifloxacin Concentrations Higher Than Gatifloxacin in Eye Surgery: Presented at ARVO

By Michael Casasnovas

FT. LAUDERDALE, F.L. -- May 4, 2006 -- Higher antimicrobial activity and concentration of moxifloxacin (Vigamox) when compared to gatifloxacin (Zymar) may help prevent common ocular pathogens associated with endophthalmitis and keratitis, according to research presented here at the Association for Research in Vision and Ophthalmology (ARVO) annual meeting.

"Following single topical administration, moxifloxacin intracorneal levels exceeded the minimum inhibitory concentration for the majority of pathogens causing bacterial keratitis and endophthalmitis," said Ed Holland, MD, director of cornea and external diseases, Cincinnati Eye Institute, Cincinnati, Ohio.

Immediate antibiotic treatment is a key in preventing corneal scarring and potential visual acuity loss or blindness, Dr. Holland said. Fifty patients in need of penetrating keratoplasty were enlisted in this study at 6 centers across the United States. They were divided evenly into 2 groups to receive either moxifloxacin or gatifloxacin on the day of the surgery. These 2 groups were divided into 4 different times (15 minutes, 30 minutes, 1 hour, or 2 hours) for sample collection.

Researchers used tuberculin syringes to transfer approximately 0.15 mL of aqueous humor, withdrawn from the anterior chamber, into a 1.5 mL conical polypropylene tube. They extracted a corneal button and stored it in a polypropylene cryogenic [storage] tube. Until researchers were prepared for analysis, the samples were frozen at -20°C for storage.

Researchers analyzed the amount of moxifloxacin and gatifloxacin in the corneal tissue and the aqueous humor determining their ocular penetration.

"Over the 2-hour collection period, mean stromal levels of moxifloxacin were at least 2-fold higher than those of gatifloxacin. Similarly, the mean levels of moxifloxacin in the corneal epithelium, endothelium, and aqueous humor were markedly higher at each time point than those of gatifloxacin," said Dr. Holland in the poster presentation on May 3^rd.

The results were significant (P <.05) for the area under the concentration-time curve, where it was observed that moxifloxacin levels were 2.3 to 4 times greater than that of gatifloxacin at all 4 collection times.

When compared with the predicted corneal wound healing, researchers noted a quicker response to those on moxifloxacin at days 1, 3, and 7.


[Presentation title: Human Cornea and Aqueous Humor Concentrations of Moxifloxacin and Gatifloxacin Following Topical Dosing With Vigamox Solution or Zymar. Abstract 3577]

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