The release of insoluble antibiotics from collagen ocular inserts in vitro and their insertion into the conjunctival sac of cattle

Ophthalmic Drug Delivery Systems for Antibiotherapy-A Review

The last fifty years, ophthalmic drug delivery research has made much progress, challenging scientists about the advantages and limitations of this drug delivery approach. Topical eye drops are the most commonly used formulation in ocular drug delivery. Despite the good tolerance for patients, this topical administration is only focus on the anterior ocular diseases and had a high precorneal loss of drugs due to the tears production and ocular barriers. Antibiotics are popularly used in solution or in ointment for the ophthalmic route. However, their local bioavailability needs to be improved in order to decrease the frequency of administrations and the side effects and to increase their therapeutic efficiency. For this purpose, sustained release forms for ophthalmic delivery of antibiotics were developed. This review briefly describes the ocular administration with the ocular barriers and the currently topical forms. It focuses on experimental results to bypass the limitations of ocular antibiotic delivery with new ocular technology as colloidal and in situ gelling systems or with the improvement of existing forms as implants and contact lenses. Nanotechnology is presently a promising drug delivery way to provide protection of antibiotics and improve pathway through ocular barriers and deliver drugs to specific target sites.

Ocular preparations: the formulation approach

The main aim of pharmacotherapeutics is the attainment of an effective drug concentration at the intended site of action for a sufficient period of time to elicit the response. A major problem being faced in ocular therapeutics is the attainment of an optimal concentration at the site of action. Poor bioavailability of drugs from ocular dosage forms is mainly due to the tear production, non-productive absorption, transient residence time, and impermeability of corneal epithelium. This article reviews: (1) the barriers that decrease the bioavailability of an ophthalmic drug; (2) the objectives to be considered in producing optimal formulations; and (3) the approaches being used to improve the corneal penetration of a drug molecule and delay its elimination from the eye. The focus of this review is on the recent developments in topical ocular drug delivery systems, the rationale for their use, their drug release mechanism, and the characteristic advantages and limitations of each system. In addition, the review attempts to give various analytical procedures including the animal models and other models required for bioavailability and pharmacokinetic studies. The latter can aid in the design and predictive evaluation of newer delivery systems. The dosage forms are divided into the ones which affect the precorneal parameters, and those that provide a controlled and continuous delivery to the pre- and intraocular tissues. The systems discussed include: (a) the commonly used dosage forms such as gels, viscosity imparting agents, ointments, and aqueous suspensions; (b) the newer concept of penetration enhancers, phase transition systems, use of cyclodextrins to increase solubility of various drugs, vesicular systems, and chemical delivery systems such as the prodrugs; (c) the developed and under-development controlled/continuous drug delivery systems including ocular inserts, collagen shields, ocular films, disposable contact lenses, and other new ophthalmic drug delivery systems; and (d) the newer trends directed towards a combination of drug delivery technologies for improving the therapeutic response of a non-efficacious drug. The fruitful resolution of the above-mentioned technological suggestions can result in a superior dosage form for both topical and intraocular ophthalmic application.

Infectious bovine keratoconjunctivitis: a review

The economic impact of infectious bovine keratoconjunctivitis (IBK) warrants continued investigation of the mechanisms by which Moraxella bovis survives on and colonizes the corneal surface. Virulent strains of M bovis produce hemolysin and exhibit different plasmid profiles than nonvirulent strains. Interactions among host, environment, vector, season, and concurrent infection influence the prevalence of IBK. Mycoplasma sp. or infectious bovine rhinotracheitis virus may enhance or hasten the disease process. The manifestations of IBK may range from mild conjunctivitis to severe ulceration, corneal perforation, and blindness. Treatment of IBK is dictated by economic considerations, intended animal use, and feasibility of administration. Antibiotic therapy is aimed at achieving drug concentrations in tears to meet or exceed the minimum inhibitory concentration for prolonged periods. At present, IBK is not a preventable disease. Affected animals must be separated from the herd and vector control vigorously instituted. Carrier animals must be identified and removed from the herd. Vaccination trials have been unsuccessful because of pili antigen cross-reactivity, variable strains, and uncontrolled environmental factors. Recent investigations have determined that M bovis may utilize host iron sources via iron-repressible outer membrane proteins and siderophores for growth. Elucidation of normal defense mechanisms of the bovine eye may lead to new strategies to enhance the immune response against M bovis.

Collagen--biomaterial for drug delivery

The use of collagen as a biomaterial is currently undergoing a renaissance in the tissue engineering field. The biotechnological applications focus on the aspects of cellular growth or delivery of proteins capable of stimulating cellular response. However, basic knowledge about collagen biochemistry and the processing technology in combination with understanding of the physico-chemical properties is necessary for an adequate application of collagen for carrier systems. The purpose of this review article is to summarize information available on collagen dosage forms for drug delivery as well as to impart an overview of the chemical structures and the galenical properties including detailed description of the processing steps - extraction, purification, chemical crosslinking and sterilization. The most successful and stimulating applications are shields in ophthalmology, injectable dispersions for local tumor treatment, sponges carrying antibiotics and minipellets loaded with protein drugs. However, the scientific information about manipulating release properties or mechanistic studies is not as abundant as for some synthetic polymers.

Ocular drug delivery in veterinary medicine

This paper provides a comprehensive overview of the various approaches currently used in the development of ocular drug delivery systems for the treatment of ocular diseases in animals. It is obvious from the literature that most of the products that are currently available are derived from human medicine without consideration given to the differences which exist between the anatomy and physiology of the eye of various animal species which ultimately affect product design and performance. As a result, many of the products for animal use seem in many circumstances inappropriate for animal care. The article deals with some aspects of eye anatomy and physiology of different animals, and then provides an overview of the most commonly encountered pathologies. The paper then discusses the currently available drug products and finally reviews new delivery concepts. Several hundred references are included in the paper and provide access to further information on the subject.

Principles of therapeutics

Topical administration of drugs is the treatment of choice for diseases of the anterior segment. Drug levels attained by this means are usually of short duration, however, necessitating frequent therapy or continuous perfusion if prolonged drug levels are required. A drug-delivery device (collagen shield or contact lens) or subconjunctival injections can be used to augment topical therapy if frequent treatment is not possible. Subconjunctival injections are recommended for drugs that have low solubility and, hence, low corneal penetration. Retrobulbar injections are seldom indicated, except for regional anesthesia. Systemic administration is useful for anti-inflammatory therapy but it may be difficult to establish therapeutic levels of antibiotic agents in the eye because of the blood-ocular barrier. In severe cases, intraocular injection may be required.

The concentration of penicillin in bovine conjunctival sac fluid as it pertains to the treatment of Moraxella bovis infection. (II) Topical application

Sodium benzyl penicillin, procaine penicillin and benethamine penicillin were applied into the bovine conjunctival sac as an aqueous solution or in ointment form in order to study the concentration-time profiles. The series of treatments was repeated in five animals in a random sequence. Penicillin concentration in conjunctival sac fluid (CF) was determined using the agar-well-diffusion assay technique. The data obtained were transformed to linear regression slopes. Similarity of the slopes within treatments (in five different eyes) enabled the construction of four common lines by co-variance analysis to represent each treatment. The regression coefficients of the four common lines were then compared to study the difference between treatments. Topical application of 5,000 iu sodium benzylpenicillin in aqueous solution at a concentration isotonic with 0.9% saline, produced a duration of therapeutic concentration (DTC) in CF of 12.6 +/- 1.5 h. When the same salt or other less water-soluble ones were formulated at the same concentration in an ointment base, the DTC was significantly prolonged. For all treatments, peak concentrations in CF were recorded at the first sampling and ranged between 7 iu/ml and 14 iu/ml. Sodium benzylpenicillin or procaine penicillin, both in the ointment base, produced DTCs of 38.8 +/- 2.1 h and 37 +/- 4.0 h, respectively, while the ointment formulation of benethamine penicillin produced a DTC of 56 +/- 4.5 h. The prolonged duration observed in the eye ointments can be partly accounted for by the viscous nature of the base. Other differences may be dependent on relative water solubility of each penicillin product and complexity of the surface mucosae of the eye.