Aureomycin in ophthalmology.

AUREO0MYCIN has now become established as an important and powerful antibiotic and has proved itself effective in several ophthalmological infections which failed to respond to other treatment. A preliminary' report has already been made from this clinic on the use of this drug in ophthalmology (Duke-Elder and others, 1950). The present communication describes our further experiences with this drug. In particular it has been found effective in resistant cases of conjunctivitis, blepharo-conjunctivitis, follicular conjunctivitis, and trachoma, and in some cases of keratitis and corneal ulceration. The main disadvantage of aureomycin in ocular therapeutics is its poor penetration into the eye, whether given topically, subconjunctivally, or systemically. Experimental studies of the penetrability of aureomycin into the eye of the rabbit have been made by de Roetth (1949) and by Bellows and others (1950). Their results were similar. They found that a barely therapeutic level of aureomycin in the aqueous was obtained after a very large intravenous dosage (50mg. /kg. bodyweight). Subconjunctival injection did not lead to a therapeutic level in the aqueous. Local administration of drops 0.5 per cent. to the conjunctival sac did not lead to any penetration in the intact eye. In cases of corneal .ulceration or abrasion, however, aureomycin was found to penetrate into the cornea and aqueous. Theoretically intra-ocular injection is the only possible means of its introduction into the eye, but the direct injection of aureomycin into the anterior chamber is said to produce a severe iritis, which, however, gradually settles, whereas injection into the vitreous leads to retinal degeneration and fibrous tissue formation (Azzolini and Faldi, 1950; Pritikin and others, 1950).