We are pleased to note Drs Fuller and Marcus' interest in our recentarticle.1 We agree with them that the fourth-generationfluoroquinolones, such as gatifloxacin and moxifloxacin, are poised to havean important role in the treatment and prophylaxis of endophthalmitis andother ophthalmic infections. We respectfully take issue, however, with thesuggestion that the intent of this investigation was to demonstrate the superiorityof gatifloxacin over moxifloxacin. In fact, studies are underway at our institutionthat investigate the intraocular penetration of moxifloxacin through variousroutes, including topical drops as well as a collagen shield delivery device.The point made in our article was that oral gatifloxacin is the first fourth-generation fluoroquinolone reported to achieve therapeuticlevels in the human vitreous—not that it was the best fourth-generation fluoroquinolone available. Although human dataare not currently available, future studies may in fact demonstrate that moxifloxacinachieves higher intravitreal concentration compared with gatifloxacin afteroral administration.
Hariprasad SM, Mieler WF, Holz ER. Vitreous and Aqueous Penetration of Orally Administered Gatifloxacinin Humans—Reply. Arch Ophthalmol. 2004;122(9):1409. doi:10.1001/archopht.122.9.1409