Prednisolone 0.5% / Neomycin 0.5% ear/eye drops

Purpose: Although a comprehensive knowledge of antibiotic/corticosteroid combinations is essential for the appropriate treatment of eye infections, the impact of their co-administration has not been well studied to date. A systematic pharmacodynamic/pharmacokinetic study to determine the effects of cotreatment with various antibiotics and corticosteroids was conducted. Methods: Four bacterial strains, seven antibiotics, and four corticosteroids were used in the analyses. Drug interactions were evaluated by considering antibacterial effects with a checkerboard assay and intracellular concentrations in human corneal epithelial cells. Results: The drug combinations that showed the most stable effects against Pseudomonas aeruginosa was levofloxacin-prednisolone. Stable combinations against the three types of Gram-positive bacteria were neomycin-prednisolone, ofloxacin-dexamethasone, ofloxacin-prednisolone, and polymyxin-dexamethasone. The cellular concentrations were changed for the gatifloxacin-fluorometholone, moxifloxacin-fluorometholone, tobramycin-dexamethasone, and tobramycin-prednisolone combinations. Conclusions: Loteprednol and fluorometholone reduced the antibacterial effects of all of the tested antibiotics in this study. Dexamethasone and prednisolone showed various effects in this regard, depending on the co-administered antibiotic. Prior knowledge of specific antibiotic/corticosteroid interactions provides valuable information to clinical practitioners by combining data on the antibacterial and intracellular uptake effects of their co-administration. Translational Relevance: When using antibiotics and corticosteroids, drug combinations can be selected by referring to the results of this study.

Abstract licence: CC BY-NC-ND

This study aimed to investigate the histopathological and functional effects of pirfenidone in a rat model of frozen shoulder (adhesive capsulitis). Thirty-two male Wistar Albino rats were randomly divided into four groups (n = 8 each): control, frozen shoulder (FS), pirfenidone-treated (FS + PFD), and dexamethasone-treated (FS + DEX). The FS model was induced by immobilizing the shoulder joint with plaster for 4 weeks. Treatment groups received oral pirfenidone (30 mg/kg/day) or prednisolone (3 mg/kg/day) for 30 days. Histopathological changes in the synovial membrane and fibrous capsule were evaluated with hematoxylin-eosin and Masson's trichrome staining, while shoulder joint range of motion (ROM) was measured. The FS group showed significant pathological alterations, including synovial epithelial atrophy, loss of synovial folds, hyperemia, edema, and severe capsular fibrosis. Both pirfenidone and dexamethasone treatments reduced these abnormalities. Pirfenidone was more effective in preserving collagen fiber organization and synovial fold integrity. ROM was markedly reduced in the FS group, but partial recovery occurred in both treatment groups. Pirfenidone provided greater functional improvement compared with dexamethasone. Inflammation scores did not differ significantly between groups, consistent with evaluation during the fibrotic phase. Pirfenidone attenuates fibrotic changes and improves joint mobility in an experimental frozen shoulder model. Pirfenidone improved histological fibrosis scores and ROM in this experimental model. Comparative effectiveness versus corticosteroids requires confirmation in larger, appropriately powered studies. These results emphasize the antifibrotic potential of pirfenidone and support further long-term and clinical studies to clarify its role in adhesive capsulitis management.

Abstract licence: CC BY

Objective: This study is aimed at describing a unilateral presentation of acute iris transillumination following contralateral vitrectomy with postoperative endophthalmitis. Methods: This case study is based on the medical record of a patient who presented to our hospital in 2017. Results: A 70‐year‐old female patient presented to our department with metamorphopsia and decreased vision in the right eye. She was diagnosed with a Stage 3 macular hole in the right eye for which she underwent 23G pars plana vitrectomy with gas tamponade. Postoperative topical treatment of tobramycin/dexamethasone was administered. Nine days after surgery, she presented to a different medical center with postoperative endophthalmitis in the right eye. Oral moxifloxacin was administered, an intravitreal injection with vancomycin was performed, and topical treatment with dexamethasone/chloramphenicol and neomycin/polymyxin B/dexamethasone was started. One month after surgery, she presented again to our department, this time with scleritis with associated anterior uveitis of the left eye. She was treated with oral ibuprofen, topical prednisolone acetate, and atropine sulfate, which resulted in clinical resolution. Three weeks after this episode, the left eye showed patchy transillumination of the iris matching the bilateral acute iris transillumination (BAIT) syndrome phenotype; however, the iris in the right eye remained normal. Conclusion: To the best of our knowledge, this case is the first to show a unilateral phenotype of BAIT after contralateral vitrectomy. This suggests that previous vitrectomy, injection of vancomycin, or topical corticosteroids or chloramphenicol could be protective against the development of acute iris transillumination.

Abstract licence: CC BY