Factors affecting precipitation of vancomycin and ceftazidime on intravitreal injection.

The aim of this study was to investigate the factors that affect the precipitation of vancomycin and ceftazidime which are currently used in intravitreal injections for infectious endophthalmitis. The minimum concentration required for precipitation of the 2 antibiotics was estimated by 2-fold dilution. In addition, the amount of the precipitate that formed was measured at 4, 3, 2, and 1 mL volumes, temperatures (37°C or 4°C), and in different medias (balanced salt solution plus and normal saline). When 2-fold serial dilutions of vancomycin and ceftazidime were mixed, precipitates started forming at a concentration of 12.5 mg/mL for ceftazidime and 10 mg/mL for vancomycin. The precipitation of vancomycin and ceftazidime increased at lower temperatures (4°C) and lower media volumes (1 mL). However, using a micropipette with a complete mixed media and an antibiotic (vancomycin or ceftazidime) prevented the formation of a precipitate when the other antibiotic was added. The formation of a precipitate associated with intravitreal injections was correlated with the diffusion rate of the antibiotics in the media. Precipitation increased at lower temperatures, lower media volumes, and at higher antibiotic concentrations.

Citation

Indal Park, Sang Joon Lee. Factors affecting precipitation of vancomycin and ceftazidime on intravitreal injection. Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics. 2013 Feb;29(1):23-6

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PMID: 23035974

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