Article Text
Abstract
Background Endophthalmitis is a rare but serious postoperative infectious complication following cataract surgery. According to the Agence française de sécurité sanitaire des produits de santé (AFSSAPS) recommendations 2011 there is a preventive treatment to minimise it, consisting of the administration of an intracameral injection of 0.1 ml of cefuroxime 1 mg/0.1 mL, after uncomplicated surgery. This treatment is not marketed and must be prepared within a hospital pharmacy.
Purpose To perform a literature review of studies concerning the stability of cefuroxime ocular solutions.
Materials and methods A review of the literature found 14 references, contained in Trissel's stability of compounded formulations, Handbook on injectable drugs, or databases such as Scopus. Various criteria were listed depending on the study: the concentration of the solution, the solvent, the conditions of storage and length of stability.
Results The studies were classified in a summary table. Concentrations can range from 7.5 to 60 mg/mL; the different diluents may be sodium chloride 0.9% (NaCl 0.9%), Balanced Salt Solution (BSS) or water for injections; preparations may be stored in the freezer at temperatures ranging from -21 °C to -10 °C or in the fridge at +4 °C; the expiry ranges from 24 h to one year. The hospital pharmacy of Nancy University Hospital makes series of syringes of 0.2 mL of cefuroxime 10 mg/mL in sodium chloride 0.9% in 1 mL graduated polypropylene syringes. These hospital preparations are produced once a week and stored at +4°C. Freezing assures stability of at least one month. So a cefuroxime solution of 10 mg/mL at -21 °C may be stored for 28 days in BSS or for 4 months in NaCl 0.9%.
Conclusions The mode of storage in the Nancy University Hospital should evolve to increase the length of time for which its preparations are stable. The best way to preserve for a long time is freezing.