Moxifloxacin eye drops (Apdrops - Ajanta Pharma)

This promotional topic was presented to the JDOS audience by Mr. Suvir Tiwari of Ajanta Pharma Limited.

Gaps in current generation fluoroquinolones coverage of:

Agent	248 gm +ve isolates	Streptococcus (from corneal ulcer)
Ciprofloxacin	66%	67%
Ofloxacin	64%	78%
Levofloxacin	67%	90%

Concern for the ophthalmic surgeon:

Staphylococcus, Streptococcus and Pseudomonas occurring on ocular natural flora

Atypical (Mycobacterium- non tuberculous)introduced during surgery.

Coverage of both required.

30% of Gr + Ve organisms are insensitive to current fluroquinolone.

Mechanism of Resistance to fluroquinilone

o Current FQ binds to
- DNA gyrase - Gr +ve
- DNA gyrase and topoisomerase IV to Gr -Ve

o Moxifloxacin binds to both topoisomerase

o C7 side chain impedes efflux

High solubility

o Solubility and penetration are interdependent

o Moxifloxacin is stable at physiological pH
- Prevents precipitation
- Facilitates penetration
- Increase bioavailability

Fluroquinolones are concentration dependent.

Higher conc. = More killing.

Moxifloxacin - 0.5 % concentration with excellent tissue penetration.

BAC free (Preservative Free)

o Less toxicity to cornea

o Least epithelial thining

o Maintain health and integrity of ocular surface - esp. following refractory surgery.

o Fewer problems such as dry eyes, irritation, foreign body sensation.

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