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    Fortified Antibiotic Eye Drops

    Uploaded by

    Sri Wahyuni Handayani
    This document provides instructions for preparing various fortified antimicrobial eye drops including aminoglycosides like tobramycin and gentamicin, cephalosporins like cefazolin and ceftazidime, vancomycin, linezolid, colistin, imipenem-cilastin, amphotericin B, and voriconazole. The instructions include the methods of preparation, storage requirements, and shelf lives. Safety precautions like working in a laminar air hood and using disposable syringes are emphasized. References supporting the use of these preparations are also provided.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Fortified Antibiotic Eye Drops

    Uploaded by

    Sri Wahyuni Handayani
    406 views4 pages
    This document provides instructions for preparing various fortified antimicrobial eye drops including aminoglycosides like tobramycin and gentamicin, cephalosporins like cefazolin and ceftazidime, vancomycin, linezolid, colistin, imipenem-cilastin, amphotericin B, and voriconazole. The instructions include the methods of preparation, storage requirements, and shelf lives. Safety precautions like working in a laminar air hood and using disposable syringes are emphasized. References supporting the use of these preparations are also provided.

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    Fortified Antibiotic Eye Drops

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    This document provides instructions for preparing various fortified antimicrobial eye drops including aminoglycosides like tobramycin and gentamicin, cephalosporins like cefazolin and ceftazidime, vancomycin, linezolid, colistin, imipenem-cilastin, amphotericin B, and voriconazole. The instructions include the methods of preparation, storage requirements, and shelf lives. Safety precautions like working in a laminar air hood and using disposable syringes are emphasized. References supporting the use of these preparations are also provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    406 views4 pages

    Fortified Antibiotic Eye Drops

    Uploaded by

    Sri Wahyuni Handayani
    This document provides instructions for preparing various fortified antimicrobial eye drops including aminoglycosides like tobramycin and gentamicin, cephalosporins like cefazolin and ceftazidime, vancomycin, linezolid, colistin, imipenem-cilastin, amphotericin B, and voriconazole. The instructions include the methods of preparation, storage requirements, and shelf lives. Safety precautions like working in a laminar air hood and using disposable syringes are emphasized. References supporting the use of these preparations are also provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Instructionmanualforpreparationoffortifiedantimicrobialeyedrops

    Compiledby:DrSushmitaGShah,DrNikhilSGokhale.MumbaiCorneaClub

    GeneralInstructions

    Shouldbedonebydoctororpharmacistinsidealaminarairhoodunder
    asepticprecautions.Iflaminarairhoodisnotavailable,pleaseprepare
    intheoperationroom

    Disposablesyringeshouldbeused

    Alldropsshouldbelabelleddateofpreparationanddateofexpiry
    shouldbementioned

    Prescriptiondescribingfrequencyofapplicationetcshouldalsobegiven
    tothepatient

    Storageinstructionsshouldalsobegiven.Dropswhicharetobe
    refrigeratedat4degCcanbekeptontherefrigeratordoor.

    Aminoglycosides
    1. Fortified Tobramycin: 14mg/ml(1.4%)

    Method: Add 2ml/80mg of parenteral tobramycin to commercially available tobramycin eye drops
    0.3% 5 ml (15mg/5ml).

    Shelf Life: 1 week in refrigerator at 4 degrees and 4 days in room temperature

    2. Fortified Gentamicin Eye Drops: 14mg/ml(1.4%)

    Method: Add 2ml/80mg of parenteral gentamicin to commercial gentamicin ophthalmic solution 0.3%
    5 ml (15mg/5ml).

    Shelf Life: 1 week in refrigerator at 4 degrees C and 4 days in room temperature

    3. Fortified Amikacin Eye Drops: 2.5%

    Method: Parenteral Amikacin 250mg/2ml is mixed with 8 ml artificial tears.


    Shelf Life: 7 days under refrigeration at 4 Degrees Centigrade

    Cephalosporins

    1. FortifiedCefazolinEye Drops: 50mg/ml( 5%)

    Method: Reconstitute parenteral Cefazolin 500mg with 2ml sterile water available with the injection
    and add to 8ml of artificial tears.

    Storage: Refrigerate in 4 degrees C.

    Shelf Life: 1week in refrigeration at 4 degrees C and 4 days in room temperature

    2. Fortified Ceftazidime eye drops: 50mg/ml( 5%)

    Method: Reconstitute parenteral Ceftazidime 500mg with 2ml sterile water/BSS available with the
    injection and add to 8ml of artificial tears.

    Storage: Refrigerate in 4 degrees C.

    Shelf Life: 1week under refrigeration at 4 degrees C and 3 days in room temperature

    Topical Vancomycin Eye Drops: 50mg/ml(5%)

    Method: Reconstitute 500mg of vancomycin powder for injection with 2 ml sterile water/BSS. Add to
    8ml of artificial tears.

    Storage: Refrigerate at 4 Degrees C.

    Shelf Life: 28 days at 4 Degrees C

    Topical Linezolid 2 mg/ml (0.2%)

    Method: Can use directly from parenteral Linezolid (Lancure / Adlid /Rapidline) available as
    200mg/100ml (2mg/ml) IV infusion.

    Topical Colistin 0.19%

    Method: Prepared from parenteral Colistimethate sodium powder (Xylistin) 1million


    IU/75mg

    Added to 10ml distilled water 7.5mg/ml (0.75%)

    1ml of above solution is then added to 3ml distilled water 0.19% Colistin drops
    Topical ImipenemCilastin eye drops 1%

    Method: To parenteral Imipenem(500mg)-Cilastin (500mg), add 10ml sterile water to create


    a solution of strength 50mg/ml.

    Take 1 ml of this solution and add 4 ml sterile water to make topical Imipenem 1% - 1mg/ml

    Storage - In amber coloured bottles

    Stability 3 days at 2-8 deg C

    Topical Amphotericin B 0.15%

    Method: Add 10 ml distilled or sterile water to parenteral 50mg of amphotericin B powder for
    injection. Draw 3 ml of this and add to 7ml of artificial tears eye drops.

    Storage: Refrigerate in 4 degrees.

    Shelf life: 7 days in refrigerator at 4 degrees C and 4 days in room temperature.

    Amphotericin B 5 -10 gm/0.1ml for intracameral injection

    To reconstitute 10 gm/0.1ml :

    Method: Reconstituted in BSS or sterile water

    From 5mg/ml solution of Amphotericin B (as mentioned above) take 0.2ml solution and
    add 0.8ml BSS / sterile water. Now, take 0.1ml of this solution and add 0.9ml BSS/Sterile
    water to create 0.1mg/1ml Amphotericin B equivalent to 10 gm/0.1ml. Use immediately.

    Amphotericin B 5 -10 gm/0.1ml for intrastromal injection

    Method: Same concentration as is used for intrastromal injection

    Topical Voriconazole Eye Drops 1%

    Method: Mix 20 ml ringer lactate to 200 mg voriconazole lyophilized powder.

    Label: Voriconazole eye drops 1%

    Stability: 30days at 4deg C or room temperature

    Voriconazole for intrastromal injection 50 gm/0.1ml

    Method: From1% solution voriconazole, take 1ml, add 19 ml ringer lactate to make 0.05mg/ml (50
    gm/0.1ml)
    References:

    1. External Disease and Cornea. American Academy of Ophthalmology 1999-2000.


    2. Jain R, Murthy SI, Motukupally S. Clinical outcomes of corneal graft infections caused by
    Multi - drug resistant Pseudomonas aeruginosa keratitis. Cornea 2014;33: 22-26.
    3. Prabhasawat P, Chotikavanich S, Leelaporn A. Sterility of non preservative eye drops. J Med
    Assoc Thai. 2005;88:S6-10.
    4. Karampatakis V, Papanicolaou T, Giannousis M, Goulas A et al. Stability and antibacterial
    potency of ceftazidime and vancomycin eye drops reconstituted in BSS against Pseudomonas
    aeruginosa and Staphyloccoccus aureus. Acta Ophthalmologica 2009; 87(5):555-558.
    5. Shao Y, Yao Y, Chong Gang P, Tan Y et al. Therapeutic efficacy of intracameral
    amphotericin B injection for 60 patients with keratomycosis. Int J ophthalmol 2010;3(3):257-
    260.
    6. Prakash G, Sharma N, Goel M, Titiyal JS, Vajpayee RB. Evaluation of intrastromal injection
    of voriconazole as a therapeutic adjunctive for the management of deep recalcitrant fungal
    keratitis. Am J Ophthalmol 2008; 146: 56-59.
    7. Dupuis A, Tournier A, Moal GL, Venisse N. Preparation and stability of voriconazole eye
    drop solution. Antimicrobial agents and chemotherapy; Feb 2009: 798-799.

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