| ObjectiveTo evaluate the concentration of levofloxacin in aqueous and plasma with different dosing regimens;To evaluate the time course of drug concentrations achieved in aqueous and plasma;To detective the relationship between anterior chamber depth(ACD)and the concentration of drug in aqueous humor;To detective the relationship between body mass index(BMI)and the drug concentration in plasma.MethodsA total of 90 eyes of 90 patients undergoing phacoemulsification in our hospital from July 2016 to August 2017 were included in this study.Then they were randomly divided into two groups: A(30 cases),B(60 cases).Then group A was randomly divided into A1,A2 and A3 3 sub-groups,10 cases in each group,A1: 1 drops six times a day for 1 day;A2: 1 drops four times a day for 2 days;A3: 1 drops four times a day for 3 days.Group B was administered 1 drops four times a day for 3 days plus a single topical dose at preceding surgery(7.5 min,15 min,30 min,45 min,60 min and 120 min).Aqueous samples(100ul)and venous blood samples(5ml)were simultaneously obtained immediately before surgery,the interval time of them less than 30 s.And venous blood were centrifuged at 3000 r / min for 10 min.The aqueous and serum were placed in the EP tube and stored at-80 ?refrigerator.All samples were analyzed by using high performance liquid chromatography/mass spectrometry(HPLC-MS/MS).ResultsAll data by levene's test were homogeneity.The concentrations of levofloxacin in aqueous in A1,A2 and A3 sub-groups were 327.33±90.84ng/ml,228.33±44.60ng/ml,299.00±234.55ng/ml,respectively.There is no significant difference between the sub-groups,(P=0.281).And the concentrations of levofloxacin in plasma were 28.80±17.21ng/ml,19.65±9.58ng/ml,21.86±11.86 ng/ml,respectively.There is no significant difference between the sub-groups A1,A2 and A3,(P= 0.478).In group B,the concentrations in aqueous humor at the different time were 156.83±111.10ng/ml,247.00±123.32ng/ml,333.81± 249.07 ng/ml,590.80±320.03ng/ml,336.00±225.69ng/ml,327.60±173.21ng/ml,respectively.The highest concentration of drug in aqueous humor at 45 min,there is significant difference between 45 min and other times(P=0.000,0.000,0.010,0.012,0.029).The drug concentrations in the plasma were 21.53±10.22 ng/ml,26.53±6.56ng/ml,23.92±7.95ng/ml,34.79±14.06ng/ml,19.70±13.87ng/ml,19.70±13.87ng/ml,respectively.The highest concentration of drug in plasma at 45 min,there is significant difference between 45 min and other times other 15min(P=0.010,0.033,0.05,0.016).The concentration of drug in plasma was much lower than that in aqueous humor.There was no significant difference(P= 0.838)in the aqueous humor concentration in different ACD groups.The concentrations of drug in plasma were significant difference according to the BMI groups(P=0.034).The greater the BMI,the lower the drug concentration in plasma.ConclusionsWith dosing regimens 1 drops six times a day for 1 day or 1 drops four times a day for 2-3 days preoperatively can reach the MIC90 of levofloxacin against some common pathogens of postoperative endophthalmitis.The effect of dosing regimens A1 is the best.The concentration of levofloxacin reached its highest level at 45 min after a single dose.The concentration of drug in plasma was much lower than that in aqueous humor.ACD does not affect the drug concentrations in the aqueous humor.BMI can influence the concentration of drug in plasma,and the larger the BMI,the lower the drug concentration in plasma. |
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