Vitreal Penetration of Oral and Topical Moxifloxacin in Humans

Purpose To investigate the vitreal penetration of moxifloxacin after oral and topical administration. Design Prospective, nonrandomized clinical trial. Methods Twenty-four patients were assigned to one of four dosing groups: control (n = 3), which received no medication; oral (n = 8), which received two 400 mg oral doses of moxifloxacin before surgery; topical (n = 8), which received one drop of topical moxifloxacin 0.5% every 15 minutes for the hour preceding surgery; and combined (n = 5), which received two 400 mg oral doses and one drop of topical moxifloxacin 0.5% hourly for 18 hours prior to surgery. Vitreous samples were obtained and analyzed. Results Control, below quantifiable levels; oral, 1.553 ± 0.33 μg/ml; topical, 0.027 μg/ml; and combined, 2.219 ± 0.71 μg/ml. One topical patient developed postoperative endophthalmitis. Conclusions In contrast to topical moxifloxacin, oral moxifloxacin achieves significant levels in the noninflamed human vitreous.