A Pharmaceutical Service to Ophthalmology Patients:Studies on Cefuroxime Preparations

Abstract

The Pharmaceutical Department at the Birmingham and Midland Eye Hospital frequently receives requests for information about the dosage and preparation of periocular and intraocular injections and the preparation of extemporaneously prepared eye drops. The major national reference source for both subjects is the Moorfields Eye Hospital Pharmacopoeia. Apart from this information source reference must be made to original papers on the subject. The first part of this project is concerned with an investigation into the practices of other hospitals treating ophthalmic patients regarding ophthalmic injections and extemporaneously prepared eye drops. A questionnaire was distributed to 110 hospitals with dedicated ophthalmic beds. The results showed a close parallel between the preparation of extemporaneous antimicrobial eye drops and the use of ophthalmic injections of the same antibiotic. The general response received to the questionnaires indicated that the provision of information on the subject of ophthalmic injections was desirable and necessary, and a booklet about these injections has been prepared. It was evident from the responses received to the questionnaires that formulation and stability information was available for those penicillin eye drops which are most frequently prepared. However the use of cephalosporin eyedrops is becoming increasingly important with the emergence of methicillin-resistant micro-organisms. No formulation or stability work has been published about the preparation of cefuroxime eye drops, the most widely reported preparation in this group. The second part of this project investigates the formulation and stability of cefuroxime eye drops, when prepared in a number of artificial tear solutions, and concludes that the preparation of Cefuroxime 5% eye drops in Sno Tears is the most appropriate formulation.