Variability of Antibiotic Concentration in Solutions for Intracameral Administration in Cataract Surgery

Abstract

Purpose: to evaluate the variability of cefuroxime concentration for intracameral administration during preparation of ex tempore solutions under conditions of real clinical practice.Materials and methods. Two operating room nurses participated in the study, each prepared 20 samples of cefuroxime solution for intracameral administration according to a uniform dilution protocol. The concentration of antibiotic in the solutions was measured by photocolorimetric method.Results. The experiment modelling the conditions of real clinical practice demonstrated a significant difference of cefuroxime concentrations in solutions prepared ex tempore. The mean antibiotic concentration in samples prepared by 2 nurses was 1.189 [1.075; 1.383] mg/ml and 1.019 [0.984; 1.10] mg/ml, respectively, p = 0.0002. The range of variation was 0.4 mg/ml, or 40.5 % of the minimum recorded value.Conclusion. High variability of cefuroxime concentration during ex tempore preparation may lead to a number of undesirable events. Unintentional overdosing causes the development of serous retinal detachment and anterior chamber toxic syndrome. Low antibiotic content can be considered as one of the reasons for the development of infectious complications caused by cefuroxime-sensitive bacterial strains. Improvement of approaches, substances and routes of administration of antimicrobial agents to improve the safety of cataract surgery in the conditions of changing structure and increasing resistance of ocular microbiota seems to be an urgent scientific task.

Keywords

• phacoemulsification
• cefuroxime
• antibiotic
• side effect
• toxic reaction