Poor penetration of cefcapene into aqueous humor after oral administration of cefcapene pivoxil to patients undergoing cataract surgery
- J Infect Chemother. 2020 Feb;26(2):312-315. doi: 10.1016/j.jiac.2019.08.004.
- 1. Department of Infectious Diseases, Ophthalmology, and Pharmacy, The University of Tokyo Hospital, Tokyo, Japan. Electronic address: [email protected].
- 2. Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan.
- 3. Department of Pharmacy, The University of Tokyo Hospital, Tokyo, Japan; The Education Center for Clinical Pharmacy, Graduate School of Pharmaceutical, Sciences, The University of Tokyo, Tokyo, Japan.
- 4. Department of Pharmacy, The University of Tokyo Hospital, Tokyo, Japan.
- 5. Department of Infectious Diseases, Ophthalmology, and Pharmacy, The University of Tokyo Hospital, Tokyo, Japan.
Objectives: Studies on the penetration of orally administered cephalosporins to the aqueous humor are scarce. Therefore, in this study, we determined the concentration of cefcapene, a third-generation cephalosporin administrated orally as pivalate ester (cefcapene pivoxil), in the aqueous humor of patients undergoing Cataract surgery to assess its potential for preventing postoperative endophthalmitis.
Methods: Forty-four patients were administered a single dose of 100 mg cefcapene pivoxil preoperatively. Blood and aqueous humor samples were obtained at the time of surgery, and cefcapene concentrations were measured using ultra-performance liquid chromatography with tandem mass spectrometric detection.
Results: The samples were obtained from 41 eyes of 39 patients (two patients underwent surgery in both eyes). The median cefcapene concentrations in the aqueous humor after 1-2 h, 2-3 h, and later than 3 h were 8.3, 18.4, and 23.7 ng/mL, respectively. The median cefcapene concentrations in serum after 1-2 h, 2-3 h, and later than 3 h were 198.5, 287.2, and 170.3 ng/mL, respectively. Aqueous humor penetration of cefcapene after 1-2 h, 2-3 h, and later than 3 h was 4.1, 7.9, and 13.5% respectively.
Conclusions: Aqueous humor penetration of orally-administered cefcapene pivoxil in patients undergoing Cataract surgery was poor. Therefore, cefcapene pivoxil was unlikely to be effective for preventing endophthalmitis after Cataract surgery.