Levofloxacin beats rivals in infection control

Topical levofloxacin penetrates better than ofloxcin or ciprofloxacin into the aqueous of eyes with functioning filtering blebs, concludes a study published in the March issue of the British Journal of Ophthalmology.

Louis Cantor and colleagues from the Indiana University School of Medicine, Indianapolis, USA conducted an investigator-masked study to compare the penetration of levofloxacin, ofloxacin and ciprofloxacin.

A total of 48 patients with functioning filtering blebs requiring cataract surgery were randomized into six groups of eight patients. Groups one, two and three received topical ofloxacin 0.3%, ciprofloxacin 0.3% and levofloxacin, respectively. Groups four, five and six received the same treatment with the corresponding oral dose of ofloxacin 400 mg, ciprofloxacin 400 mg and levofloxacin 250 mg. Aqueous antibiotic levels were determined by mass spectrometry of aqueous samples from each subject.

The mean aqueous level for topical levofloxacin was significantly higher than those achieved by topical ofloxacin or ciprofloxacin (p=0.02 and 0.01, respectively). Meanwhile, the combination of topical oral levofloxacin was significantly higher than topical levofloxacin alone (p=0.05).

The results of this study suggest that the combination of oral and topical levofloxacin may be preferable in the treatment of bleb-associated infections.