Adjunctive antibiotics in the treatment of acute bacterial endophthalmitis following cataract surgery

Hooper, Claire; Lightman, Sue; Pacheco, Patricio; Tam, Patrick M K; Khan, Aldrin; Taylor, Simon

doi:10.1111/j.1755-3768.2011.02365.x

Cited by 24 publications

(14 citation statements)

References 4 publications

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“…The EVS also did not evaluate the role of antibiotics administered orally (Barry et al 2013). In 2012, Hoper et al compared the use of oral ciprofloxacin versus moxifloxacin in PE treatment and showed that adjunctive oral moxifloxacin may decrease the need for repeated intravitreal injections of antibiotics and improve clinical outcome (Hooper et al 2012). Also, levofloxacin has been shown to have broad spectrum of activity against Gram-positives and to achieve effective intravitreal levels after oral administration; thus, it can be a potential adjunctive antibiotic in PE treatment.…”

Section: Discussionmentioning

confidence: 99%

The treatment of postoperative endophthalmitis: should we still follow the endophthalmitis vitrectomy study more than two decades after its publication?

Grzybowski

Turczynowska

Kuhn

2017

Acta Ophthalmologica

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Conducted in the early 1990s Endophthalmitis Vitrectomy Study (EVS) have helped in establishing reasonable guidelines for the management of infectious postoperative endophthalmitis. However at present, more than 20 years after its publication, tremendous progress has been introduced in vitrectomy technology, which now permits the vitreoretinal surgeon to perform surgery more safely, and with better outcomes. Moerover, performing a complete vitreous removal, along with the moving up of the surgical intervention to as early as possible allows the prevention of complications that would limit the functional improvement postoperatively. Thus, it is now highly needed to re-evaluate the conclusions of the EVS study.

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Section: Discussionmentioning

confidence: 99%

The treatment of postoperative endophthalmitis: should we still follow the endophthalmitis vitrectomy study more than two decades after its publication?

Grzybowski

Turczynowska

Kuhn

2017

Acta Ophthalmologica

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“…Therefore, a comparison of the PE risk between this study and other studies is only meaningful if the other studies have implemented the use of intracameral antibiotics as these are known to decrease the PE risk (Montan et al 2002;ESCRS Endophthalmitis Study Group 2007;Lundstrom et al 2007;Garat et al 2009;Friling et al 2013;Shorstein et al 2013). The use of systemic antibiotics in the treatment of PE is debated (Hooper et al 2012) and so is the use of postoperative topical antibiotics. The cases of PE in this study were treated either with or without systemic antibiotics and most of the cases received a mixture of topical corticosteroids and antibiotics postoperatively.…”

Section: Discussionmentioning

confidence: 94%

“…The use of systemic antibiotics in the treatment of PE is debated (Hooper et al. ) and so is the use of postoperative topical antibiotics. The cases of PE in this study were treated either with or without systemic antibiotics and most of the cases received a mixture of topical corticosteroids and antibiotics postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Outsourced cataract surgery and postoperative endophthalmitis

Bjerrum

Kiilgaard

Mikkelsen

et al. 2013

Acta Ophthalmologica

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ABSTRACT.Purpose: To compare the risk of postoperative endophthalmitis (PE) after cataract surgery at eye departments in public hospitals and private hospitals/eye clinics and to evaluate if the Danish National Patient Registry (NPR) is a reliable database to monitor the PE risk. Methods: Postoperative endophthalmitis cases were retrospectively identified via the NPR and chart review in order to confirm PE cases that had cataract surgery in the calendar period 2002-2010. Results: We identified 39 cases of PE after 107 701 registered public cataract operations; PE risk = 0.036 per 1000 operations and 27 cases of PE after 36 760 registered private operations; PE risk = 0.073 per 1000 operations. There was homogeneity in the PE risk among the eye departments in public hospitals (p = 0.6), but heterogeneity in the PE risk among the private hospitals/eye clinics (p = 0.0001). Six private hospitals/eye clinics had a statistically significantly higher PE risk compared with the eye departments in public hospitals. In all, 98% of public cataract surgery was registered in the NPR compared with 38% of private cataract surgery. The private hospitals/eye clinics with the highest PE risk after registered cataract surgery had many cases of PE where the causative cataract operation was not registered with the NPR. Conclusion: A few private hospitals/eye clinics had a statistically significantly higher PE risk than the PE risk at the eye departments in public hospitals. The lack of registration with the NPR by the private hospitals/eye clinics suggests that better monitoring of cataract surgery is needed in Denmark to reduce risk and to improve quality.

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“…However, this finding has been questioned because of the exclusion of patients with severe endophthalmitis and the choice of adjunctive antibiotics: ceftazidime has poor activity against the dominant Gram-positive organisms and amikacin has very limited intraocular penetration. Since then, only small studies have evaluated the efficacy of systemic antibiotic therapy in endophthalmitis with varying methodologies and results [12][13].…”

Section: The Role Of Systemic Antibioticsmentioning

confidence: 99%

Revisiting systemic treatment of bacterial endophthalmitis: a review of intravitreal penetration of systemic antibiotics

Brockhaus

Goldblum

Eggenschwiler

et al. 2019

Clinical Microbiology and Infection

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Background: Adjunctive systemic antibiotic therapy for treatment of bacterial endophthalmitis is controversial but common practice due to the severity of the disease. In absence of guidance documents, several antibiotic regimens are being used without applying evidence-based prescribing, thus leading to inappropriate treatment of this serious eye condition. Objectives: To summarize available data on intravitreal penetration of systemically administered antibiotics and to discuss their usefulness from a microbiological and pharmacological point of view. Sources: We performed a systematic PubMed search of studies investigating antibiotic concentrations in the vitreous after systemic administration in humans, and selected animal models. Content: The best-documented agents achieving therapeutic levels in the vitreous are meropenem, linezolid and moxifloxacin. Vancomycin, cefazoline, ceftriaxone, ceftazidime, imipenem and trimethoprim-sulfamethoxazole reach levels justifying their use in specific situations. Available data do not support the use of ciprofloxacin, levofloxacin, aminoglycosides, aminopenicillins, piperacillin, cefepime, and clarithromycin. With very limited but available promising data, the use of daptomycin and rifampicin deserves further investigation. Implications: The choice of the adjunctive systemic antibiotic agent -in situations where considered relevant for treatment -must to date be made on an individual base, considering microbiological aspects as well as operative status and inflammation of the eye. This review

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Adjunctive antibiotics in the treatment of acute bacterial endophthalmitis following cataract surgery

Cited by 24 publications

References 4 publications

The treatment of postoperative endophthalmitis: should we still follow the endophthalmitis vitrectomy study more than two decades after its publication?

The treatment of postoperative endophthalmitis: should we still follow the endophthalmitis vitrectomy study more than two decades after its publication?

Outsourced cataract surgery and postoperative endophthalmitis

Revisiting systemic treatment of bacterial endophthalmitis: a review of intravitreal penetration of systemic antibiotics

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