cefoxitin and Endophthalmitis

Intravenous injections of cefoxitin (2-g doses for adults and 40 mg/kg of body weight doses for children) were administered 90 minutes to two hours before surgery. All nine eyes had anterior segment inflammation. Samples of aqueous humor removed during surgery showed a mean cefoxitin concentration of 6.22 micrograms/ml, almost three times the concentration reported in uninflamed eyes. The greater penetration may have been the result of a breakdown in the blood-aqueous barrier. There were no complications.

Topics: Adolescent; Adult; Aqueous Humor; Cefoxitin; Child; Endophthalmitis; Female; Humans; Injections, Intravenous; Male; Middle Aged; Uveitis

We administered 2 g of cefoxitin to 25 patients before cataract surgery. An additional 23 patients received 500 mg of probenecid 30 minutes before the 2-g doses of cefoxitin. Average aqueous humor levels of 1.54, 3.16, 2.46, 1.22, and 0.82 microgram/ml were achieved at 30 minutes and one, two, four, and six hours, respectively, after the 2-g dose. The addition of probenecid prolonged significant aqueous humor levels. Therapeutic levels against common gram-positive pathogens were consistently achieved at two hours after injection without probenecid and from two to four hours after injection with probenecid. Therapeutic levels effective against Enterobacteriaceae were inconsistent.

Topics: Aqueous Humor; Cataract Extraction; Cefoxitin; Endophthalmitis; Humans; Probenecid; Surgical Wound Infection