Iris Prolapse Medication

Updated: May 22, 2015
  • Author: Guruswami Giri, MD, FRCS; Chief Editor: Hampton Roy, Sr, MD  more...
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Medication

Medication Summary

Systemic antibiotics are used for prophylaxis against infection, especially in cases of iris prolapse following trauma. Endophthalmitis is uncommon but has a poor prognosis in the setting of ocular trauma. Antibiotics should cover both gram-negative organisms and gram-positive organisms, including Bacillus, which is the most common cause of posttraumatic endophthalmitis.

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Antibiotics

Class Summary

Prophylaxis against infection.

Vancomycin (Vancoled, Vancocin, Lyphocin)

Provides excellent coverage of gram-positive organisms, including Bacillus. To avoid toxicity, current recommendation is to assay vancomycin trough levels after third dose drawn 0.5 h prior to next dose. Use creatinine clearance to adjust dose in patients with renal impairment.

Ceftazidime (Tazidime, Fortaz, Ceptaz, Tazicef)

Third-generation cephalosporin with broad-spectrum, gram-negative activity; lower efficacy against gram-positive organisms; higher efficacy against resistant organisms. Arrests bacterial growth by binding to one or more penicillin-binding proteins.

Gatifloxacin ophthalmic (Zymar)

Quinolone that has antimicrobial activity based on ability to inhibit bacterial DNA gyrase and topoisomerases, which are required for replication, transcription, and translation of genetic material. Quinolones have broad activity against gram-positive and gram-negative aerobic organisms. Differences in chemical structure between quinolones have resulted in altered levels of activity against different bacteria. Altered chemistry in quinolones result in toxicity differences.

Moxifloxacin ophthalmic (Vigamox)

Indicated to treat bacterial conjunctivitis. Elicits antimicrobial effects. Inhibits topoisomerase II (DNA gyrase) and IV enzymes. DNA gyrase is essential in bacterial DNA replication, transcription and repair. Topoisomerase IV plays a key role in chromosomal DNA portioning during bacterial cell division.

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