Purpose: This study compared the safety outcomes of two intracameral fluoroquinolone antibiotics, moxifloxacin and levofloxacin, as prophylaxis treatment in eyes that underwent uncomplicated cataract surgery. Methods: This is a prospective, double-masked, randomized, interventional, single-center clinical trial. Eyes with visually-significant cataracts underwent phacoemulsification and received preservative-free intracameral 0.5% moxifloxacin [58 eyes (M group)] or 0.5% levofloxacin [56 eyes (L group)] at the end of the surgery as antibiotic prophylaxis. The following safety parameters were evaluated postoperatively at Day 1, Week 1 and Month 1: central retinal thickness (CRT), macular volume (MV), central corneal thickness (CCT), and endothelial cell density (ECD). In-between group comparison was made at each of the 4 study visits using Student’s t-test. Results: Both M and L groups had similar baseline characteristics. There were no significant differences in CRT, MV, CCT and ECD between the 2 groups at each time point in the study. There were no significant differences in the mean changes in CRT, MV, CCT and ECD from baseline to final visit between the 2 groups. No study-related adverse events were observed during the study period. Conclusion Intracameral application of preservative-free 0.5% moxifloxacin and 0.5% levofloxacin appear to have similar safety outcomes when used as antibacterial prophylaxis among eyes undergoing cataract surgery. Based on the results, both fluoroquinolone agents are potentially suitable options for endophthalmitis chemoprophylaxis.
Levofloxacin ; Moxifloxacin ; Fluoroquinolones

Objective: To determine the safety of intracamerally injected preservative-free 0.5% moxifloxacin/0.1% dexamethasone fixed-dose combination on the corneal endothelium in a rabbit model and compare it to intracamerally injected preservative-free 0.5% moxifloxacin. Methods: This experimental study included twenty eyes from ten albino rabbits. The eyes were assessed for baseline corneal clarity and anterior chamber (AC) inflammation using slit-lamp biomicroscopy. A specular microscope measured the corneal endothelial cell density (ECC) and corneal thickness (CT). Intracameral injections of 0.1 mL 0.5% moxifloxacin ophthalmic solution were administered to the 10 right eyes (IPFM group) and 0.1 mL of 0.5% moxifloxacin/0.1% dexamethasone fixed-dose preparation were administered to the 10 left eyes (IPFMDex group). In both groups, ECC, CT, corneal clarity, and AC inflammation at Day 1 (one day post-injection) and Day 7 (seven days post-injection) were compared with Day 0 (baseline). The IPFMDex group was also compared with the IPFM group at Days 0, 1, and 7. The endothelial cells of harvested corneas from both groups at Day 1 and 7 were stained with trypan blue and alizarin red, and compared for endothelial cell damage (ECD). Data were analyzed using paired and independent sample t-tests. Results: In both the IPFM and IPFMDex groups, ECC and CT at Day 1 (IPFM: ECC p=0.07, CT p=0.76; IPFMDex: ECC p=0.41, CT p=0.94) and Day 7 (IPFM: ECC p=0.95, CT p=0.28; IPFMDex: ECC p=0.29, CT p=0.34) were not different from Day 0 (baseline). No significant difference in ECC, CT, and ECD were found between the IPFM and IPFMDex groups at Day 1 (ECC p=0.82, CT p=0.36, ECD p=0.96) and Day 7 (ECC p=0.95, CT p=0.22, ECD p=0.61). Throughout the study, the cornea in both groups were clear and showed no signs of AC inflammation. Conclusion Intracameral injection of preservative-free moxifloxacin/dexamethasone fixed-dose formulation was safe on the rabbit corneal endothelium and was no different from preservative-free moxifloxacin.
Moxifloxacin ; Dexamethasone ; Endothelium, Corneal

OBJECTIVE: To investigate the retinal toxicity of different doses of moxifloxacin after intravitreal injection into rabbit eyes. METHODS: Eight male rabbits were divided into four groups; 2 rabbits each were injected intravitreally with moxifloxacin 48 ug, 240 ug, 480 ug, and normal saline solution. Ocular toxicity was assessed at day 3 and day 7 by slit-lamp biomicroscopy, ophthalmoscopy, and histology. RESULTS: All eyes showed no abnormalities on histologic evaluation. No relevant complications were found during slit-lamp biomicroscopy and indirect ophthalmoscopy. CONCLUSION: Intravitreal injection of 480 ug or less of moxifloxacin did not produce retinal toxicity histologically in rabbit eyes.
Animal ; MOXIFLOXACIN ; ENDOPHTHALMITIS ; INTRAVITREAL INJECTIONS

OBJECTIVE: To determine the safety of intracamerally injected preservative-free 0.5% moxifloxacin/0.1% dexamethasone fixed-dose combination on the corneal endothelium in a rabbit model and compare it to intracamerally injected preservative-free 0.5% moxifloxacin.

METHODS: This experimental study included twenty eyes from ten albino rabbits. The eyes were assessed for baseline corneal clarity and anterior chamber (AC) inflammation using slit-lamp biomicroscopy. A specular microscope measured the corneal endothelial cell density (ECC) and corneal thickness (CT). Intracameral injections of 0.1 mL 0.5% moxifloxacin ophthalmic solution were administered to the 10 right eyes (IPFM group) and 0.1 mL of 0.5% moxifloxacin/0.1% dexamethasone fixed-dose preparation were administered to the 10 left eyes (IPFMDex group). In both groups, ECC, CT, corneal clarity, and AC inflammation at Day 1 (one day post-injection) and Day 7 (seven days post-injection) were compared with Day 0 (baseline). The IPFMDex group was also compared with the IPFM group at Days 0, 1, and 7. The endothelial cells of harvested corneas from both groups at Day 1 and 7 were stained with trypan blue and alizarin red, and compared for endothelial cell damage (ECD). Data were analyzed using paired and independent sample t-tests.

RESULTS: In both the IPFM and IPFMDex groups, ECC and CT at Day 1 (IPFM: ECC p=0.07, CT p=0.76; IPFMDex: ECC p=0.41, CT p=0.94) and Day 7 (IPFM: ECC p=0.95, CT p=0.28; IPFMDex: ECC p=0.29, CT p=0.34) were not different from Day 0 (baseline). No significant difference in ECC, CT, and ECD were found between the IPFM and IPFMDex groups at Day 1 (ECC p=0.82, CT p=0.36, ECD p=0.96) and Day 7 (ECC p=0.95, CT p=0.22, ECD p=0.61). Throughout the study, the cornea in both groups were clear and showed no signs of AC inflammation.

CONCLUSION: Intracameral injection of preservative-free moxifloxacin/dexamethasone fixed-dose formulation was safe on the rabbit corneal endothelium and was no different from preservative-free moxifloxacin.

Animal ; Endothelium, Corneal ; Moxifloxacin ; Alizarin ; Dexamethasone ; Slit Lamp ; Aza Compounds ; Anterior Chamber ; Cornea ; Anthraquinones ; Endothelial Cells ; Inflammation ; Ophthalmic Solutions

Objective: Moxifloxacin (MFX) shows good activity against and can be a possible antibiotic therapy to treat infection; however, other studies have shown a lower or no activity. We aimed to evaluate MFX activity against using zebrafish (ZF) model . Methods: A formulation of labeled with CM-Dil was micro-injected into ZF. Survival curves were determined by recording dead ZF every day. ZF were lysed, and colony-forming units (CFUs) were enumerated. Bacteria dissemination and fluorescence intensity in ZF were analyzed. Inhibition rates of MFX and azithromycin (AZM, positive control) were determined and compared. Results: Significantly increased survival rate was observed with different AZM concentrations. However, increasing MFX concentration did not result in a significant decrease in ZF survival curve. No significant differences in bacterial burdens by CFU loads were observed between AZM and MFX groups at various concentrations. Bacterial fluorescence intensity in ZF was significantly correlated with AZM concentration. However, with increasing MFX concentration, fluorescence intensity decreased slightly when observed under fluorescence microscope. Transferring rates at various concentrations were comparable between the MFX and AZM groups, with no significant difference. Conclusion MFX showed limited efficacy against using ZF model. Its activity needs to be confirmed.
Animals ; Anti-Bacterial Agents ; pharmacology ; Disease Models, Animal ; Moxifloxacin ; pharmacology ; Mycobacterium Infections, Nontuberculous ; drug therapy ; Mycobacterium abscessus ; drug effects ; Zebrafish

Legionella pneumonia (LP) is a rare systemic infectious disease, which is often misdiagnosed by clinicians due to the atypical symptoms. A middle-aged man who suffered from fever and dyspnea was diagnosed as community acquired pneumonia (CAP) in Changsha Central Hospital in March 2015. The treatment was unsatisfied firstly. The patients showed further symptoms of rhabdomyolysis, acute liver and renal failure, and impaired neural functions, who was diagnosed as LP with multiple organ failure based on a positive test for Legionella antibody. The patient was recovered after treated with moxifloxacin combined with azithromycin and continuous renal replacement therapy. LP should be paid attention when patient was diagnosed as CAP and failed to be treated. The satisfied outcome is achieved after application of macrolide, quinolones and comprehensive treatments.
Anti-Bacterial Agents ; Community-Acquired Infections ; Fluoroquinolones ; Humans ; Legionella ; Legionnaires' Disease ; Male ; Middle Aged ; Moxifloxacin ; Multiple Organ Failure ; Pneumonia, Bacterial

OBJECTIVE: To determine the safety of intracameral moxifloxacin 0.5% ophthalmic solution in cataract surgery given at a dose of 500 mg/0.1 mL.
METHODS: Medical records of uncomplicated phacoemulsification performed between January 2009 and December 2010 were reviewed. Each eye received 0.1 mL intracameral moxifloxacin (0.5% ophthalmic solution containing 500 mg of moxifloxacin) prophylactically. Outcome measures included anterior chamber cells and flare (Hogan System), corneal thickness, endothelial cell density, visual acuity, and intraocular pressure.
RESULTS: 353 eyes of 244 patients, mean age of 67.51 ± 9.22 years, were included into the study. All patients completed follow-up to 3 weeks, with 79 patients (103 eyes) followed up to 3 months. All eyes had 20/40 or better vision at 3 weeks and 3 months postoperatively. Trace to +2 anterior chamber cells and flares were observed in 96% of eyes on day 1 postsurgery. All had quiet anterior chambers at subsequent follow-up examinations. Intraocular pressures recorded postoperatively were not significantly different. Mean endothelial cell count (ECC) postoperatively were 2473.25 cells/mm2 at 3 weeks and 2468.42 cells/mm2 at 3 months and were not significantly different from baseline (2586.57 cells/mm2) (p = 0.07 and 0.12 respectively). The mean central corneal thickness postoperatively at 3 weeks (551.92 µm) and at 3 months (542.67 µm ) were not different from baseline (546.48 µm) (p = 0.47). Those with diabetes mellitus showed similar results.
CONCLUSION: Intracameral moxifloxacin 0.5% appears to be safe for prophylactic use in cataract surgery. At a dose of 500 mg/0.1 mL, there was minimal anterior chamber reaction, and the corneal thickness and endothelial cell density were not significantly different from preoperative.

Human ; Male ; Female ; Aged ; Middle Aged ; Phacoemulsification ; Moxifloxacin ; Intraocular Pressure ; Aza Compounds ; Anterior Chamber ; Cataract Extraction ; Cataract ; Ophthalmic Solutions ; Diabetes Mellitus ; Endothelial Cells