Abstract
Purpose To report blockage of a commercially available ciprofloxacin bottle by white crystalline deposits. This study evaluated the ultrastructural features of the ciprofloxacin crystals.
Methods A patient underwent intensive topical treatment of an infectious corneal ulcer with commercially available ciprofloxacin 0.3% ophthalmic solution. During treatment, the patient was unable to obtain medication from the ciprofloxacin bottle and required a new prescription. Examination of the bottle revealed that about 50% of the medication remained, but compression of the bottle with any amount of force failed to deliver any medication. On closer examination, a white material partially filled the nozzle track of the bottle and was on the outer bottle near the nozzle and the inner surface of the bottle cap. These white crystalline deposits were evaluated by scanning electron microscopy.
Results Plate-like, needle, cable and spaghetti-like crystals were found. The needle crystals formed multiple petaloid patterns.
Conclusions This is the first report of blockage of a commercially available ciprofloxacin 0.3% bottle by ciprofloxacin crystals and the inability to deliver medication from the bottle. Ultrastructural study of the white crystalline deposits revealed four types of ciprofloxacin crystals.
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Neu HC . Microbiological aspects of fluoroquinolones. Am J Ophthalmol 1991;112:S15–24.
Leibowitz HM . Clinical evaluation of ciprofloxacin 0.3% ophthalmic solution for treatment of bacterial keratitis. Am J Ophthalmol 1991;112:S34–47.
Wilhelmus KR, Hyndiuk RA, Caldwell DR, Abshire RL, Folkens AT, Godio LB, for the ciprofloxacin ointment/ bacterial keratitis study group. 3% ciprofloxacin ophthalmic ointment in the treatment of bacterial keratitis. Arch Ophthalmol 1993;111:1210–8.
Insler MS, Fish LA, Silbernagel J, Hobden JA, O'Callaghan RJ, Hill JM . Successful treatment of methicillin-resistant Staphylococcus aureus keratitis with topical ciprofloxacin. Ophthalmology 1991;98:1690–2.
Kanellopoulos AJ, Miller F, Wittpenn JR . Deposition of topical ciprofloxacin to prevent re-epithelialization of a corneal defect. Am J Ophthalmol 1994;117:258–9.
John T . Ultrastructural characteristics of corneal deposits of ciprofloxacin. Ophthalmology 1994;(Suppl)101:104.
John T . Ciprofloxacin deposits on the cornea and soft contact lens: an ultrastructural study. Invest Ophthalmol Vis Sci 1995;36(Suppl):S152.
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John, T. Scanning electron microscopic study of a Ciloxan bottle blocked by ciprofloxacin crystals. Eye 15, 786–788 (2001). https://doi.org/10.1038/eye.2001.250
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DOI: https://doi.org/10.1038/eye.2001.250