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LETTER TO THE EDITOR |
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Year : 2014 | Volume
: 62
| Issue : 12 | Page : 1174 |
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Comment on: Successful use of intravitreal and systemic colistin in treating multidrug resistant Pseudomonas aeruginosa postoperative endophthalmitis
Muammer Ozcimen1, Yasar Sakarya1, Rabia Sakarya1, Sertan Goktas1, Serap Ozcimen2
1 Department of Ophthalmology, Konya Training and Research Hospital, Konya, Turkey 2 Department of Infectious Diseases and Clinical Microbiology, Konya State Hospital, Konya, Turkey
Date of Web Publication | 12-Jan-2015 |
Correspondence Address: Dr. Muammer Ozcimen Feritpasa Mah, Malazgirt Sok, Kardelen Apt. No: 14, Selcuklu, Konya Turkey
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/0301-4738.149152
How to cite this article: Ozcimen M, Sakarya Y, Sakarya R, Goktas S, Ozcimen S. Comment on: Successful use of intravitreal and systemic colistin in treating multidrug resistant Pseudomonas aeruginosa postoperative endophthalmitis. Indian J Ophthalmol 2014;62:1174 |
Dear Editor,
We read with a great interest the article entitled "successful use of intravitreal and systemic colistin in treating multidrug resistant Pseudomonas aeruginosa postoperative endophthalmitis" by Samant and Ramugade. [1] They explored the efficacy of intravitreal and intravenous colistin in postoperative endophthalmitis; however, there are some points to be cleared out.
First, the dose of intravitreal dexamethasone in the study was 10-fold greater than the recommended dose regimen. Second, there are no safety studies of colistin when given intravitreally; therefore, there is no determined safe intravitreal dose of colistin. Third, it has been reported that colistin did not reach therapeutically relevant levels in the aqueous and in the vitreous humor of rabbit eyes. [2]
We wonder why the authors used such a high concentration of dexamethasone. The intravitreal dexamethasone dose should be 0.4 mg/0.1 ml instead of 4 mg/0.1 ml. [3] It would be informative if the authors explained how they found the dose of intravitreal colistin as 0.1 mg/0.1 ml. Finally, we argue that there should be a limited role for intravenously administered colistin in the treatment of Gram-negative bacterial endophthalmitis.
References | | |
1. | Samant P, Ramugade S. Successful use of intravitreal and systemic colistin in treating multidrug resistant Pseudomonas aeruginosa post-operative endophthalmitis. Indian J Ophthalmol 2014;62:1167-70. [ PUBMED] |
2. | Ozcimen M, Ozcimen S, Sakarya Y, Sakarya R, Goktas S, Alpfidan I, et al. Ocular penetration of intravenously administered colistin in rabbit uveitis model. J Ocul Pharmacol Ther 2014;30:681-5. |
3. | ESCRS Guidelines for Prevention and Treatment of Endophthalmitis Following Cataract Surgery: Data, Dilemmas and Conclusions; 2013. |
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