Journal
JOURNAL OF OCULAR PHARMACOLOGY AND THERAPEUTICS
Volume 19, Issue 5, Pages 493-499Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/108076803322473042
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- NEI NIH HHS [EY013782] Funding Source: Medline
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Observational studies suggest that a pharmacodynamic index helps to predict the therapeutic outcome of respiratory and other infections. This study explored the prognostic importance of a ratio of the achievable corneal level for a fluoroquinolone to the fluoroquinolone's minimal inhibitory concentration (MIC) for corneal isolates of 391 patients with bacterial keratitis. The peak concentration and the area under the concentration curve (AUC) in the cornea were estimated from reported values achieved with topical ciprofloxacin. The inhibitory quotient (IQ) was calculated as the ratio of the estimated peak achievable corneal ciprofloxacin concentration to the ciprofloxacin MIC of keratitis isolates, and the area under the inhibitory curve (AUIC) was defined as the expected 24-hour AUC divided by the MIC. The probability of clinical improvement of ciprofloxacin-treated bacterial keratitis was 90% or more if ciprofloxacin's IQ was above 8 or the AUIC was greater than 151. A pharmacodynamic index relating corneal pharmacokinetic and susceptibility concentrations may correlate with the clinical response of bacterial keratitis to fluoroquinolone therapy.
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