The poor intraocular penetration of systemically administered
antibiotics has raised questions regarding their usefulness as prophylactic agents in the management of
penetrating eye injuries.
Cefazolin was administered intravenously to rabbits with
penetrating eye injuries to determine the influence of
trauma on ocular pharmacokinetics. Following a standardized
penetrating eye injury in 27 New Zealand white rabbits, animals were divided into three groups that received either three, six, or nine doses of intravenous
cefazolin every 8 h.
Cefazolin levels were then measured in the traumatized eye, the non-traumatized (control) fellow eye, and in the serum of each animal. In the three treatment groups vitreous concentrations of
cefazolin were significantly higher in traumatized eyes than in the non-injured eyes. After three doses, vitreous concentrations of
cefazolin in traumatized eyes averaged 9.1 mg/l; mean concentrations of
cefazolin in non-injured eyes were 0.6 mg/l (P < 0.0002). After six doses of intravenous
cefazolin, vitreous concentrations in traumatized eyes averaged 7.3 mg/l;
cefazolin levels in non-injured eyes were 0.6 mg/l in the non-traumatized eyes (P < 0.0005). After nine doses, vitreous
cefazolin concentrations in traumatized eyes averaged 9.7 mg/l, while mean levels in the non-traumatized eyes were all 0.05 mg/l (P < 0.0002). This work suggests that penetrating
injuries of the eye alter ocular pharmacokinetics, resulting in high intraocular concentrations of systemically administered
cefazolin.