Choosing wisely and the use of antibiotics in ophthalmic surgery: There is more than meets the eye

Grosso, Andrea; Ceruti, Piero; Scarpa, Giuseppe; Giardini, Franco; Marchini, Giorgio; Aragona, Emanuela; Bert, Fabrizio; Bandello, Francesco; Siliquini, Roberta

doi:10.1177/1120672117747043

Cited by 3 publications

(5 citation statements)

References 79 publications

(136 reference statements)

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“…Limiting indiscriminate use of antibiotics for ophthalmic use and choosing wisely can reduce AMR. [ 90 ] Furthermore, largescale microbiological surveillance and antibiotic susceptibility studies for ocular infections in India are indispensable.…”

Section: Antimicrobial Stewardship Programsmentioning

confidence: 99%

Emerging antimicrobial resistance and need for antimicrobial stewardship for ocular infections in India: A narrative review

Biswas¹,

Batra²,

Gurha

et al. 2022

Indian Journal of Ophthalmology

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Patients with ocular infections are at increased risk of vision impairment and may require immediate medical care to preserve their vision. Management of ocular bacterial infections has evolved in recent years and includes a pragmatic selection of broad-spectrum antibiotics based on the causative bacteria. Nevertheless, the treatment of bacterial ocular infections is increasingly becoming a challenge, as the causative bacterium acquires resistance to antibiotics through intrinsic and acquired methods. From an Indian perspective, along with the challenges of antibiotic resistance, there are other factors such as lack of knowledge on epidemiology, and lack of data on local susceptibility patterns of ocular pathogens that have significant impact on the management of ocular infections. This narrative review summarizes the available knowledge on prescribing antibiotics for five common ocular infections in India. It further highlights the significance of the understanding of antimicrobial susceptibility patterns across India as a cornerstone to promote rational use of ocular antibiotics. This review indicates that large-scale antimicrobial resistance surveillance studies can facilitate the synchronization of ophthalmic antimicrobial prescription policies with local antibiotic resistance patterns. Further, establishment of an antimicrobial stewardship program in ophthalmology can potentially increase the efficacy of diagnostic tools, and implement earlier adoption of effective antibiotics. Overall, this review provides consolidated information and key considerations for treatment decision-making of common ocular infections in India.

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Section: Antimicrobial Stewardship Programsmentioning

confidence: 99%

Emerging antimicrobial resistance and need for antimicrobial stewardship for ocular infections in India: A narrative review

Biswas¹,

Batra²,

Gurha

et al. 2022

Indian Journal of Ophthalmology

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“…Before administering the IVI, patients were subjected to standard preparation for intraocular surgery, including sterile draping of the surgical field, use of lid speculum and povidone-iodine 10%, irrigation of the surgical field with no post-IVI antibiotic treatment. 45,46 OR setting preparation/office setting preparation…”

Section: Patient's Characterization and Preparation For The Proceduresmentioning

confidence: 99%

Intravitreal Injections during the COVID-19 Outbreak in Northern Italy: An Innovative Approach for a High Quality and Safe Treatment

Scarpa

Urban

Scarpa

et al. 2022

European Journal of Ophthalmology

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Background Intravitreal injection (IVI) is a standard procedure performed in ophthalmology to treat several conditions, and is performed in different settings across countries. The Italian guidelines recommend this intervention is performed in an operating room to minimize the risk of infections, while in other countries, including Canada, USA and the UK, IVIs are performed in the ophthalmologist's office. The 2020 COVID-19 outbreak caused a dramatic modification in outpatient care. Consequently, non-urgent surgical activities, like IVIs, were subjected to a drastic reduction. Methods We conducted observational study which investigated the outcomes of IVIs performed in an ophthalmologist's office using a mobile laminar flow unit, the Operio mobile (Toul Meditech, Operio®) versus an operating room setting. Results Use of the Operio mobile allowed the safety performance of 3838 IVIs during COVID-19 and significantly reduced the waiting time of the first visit. This results in a faster intervention without affecting the technical IVI procedure that remained unchanged comparing the two settings. Specifically, we observed a 26% reduction in operation costs for each IVI performed in the office, which can be translated to a higher impact when considering the total number of IVIs performed over one year. Conclusion The use of the Operio mobile in an ophthalmologist's office provides flexibility to perform IVIs, assuring patient safety, reducing healthcare personnel employment times, and the waiting lists for the patients, increasing the number of surgeries and improving the cost-effectiveness of the procedure.

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“…The choice of antibiotic after cataract surgery should consider the most frequent pathogens involved in postoperative endophthalmitis, which may vary across different locations. 23 In Italy, the most diffuse bacteria causing postoperative endophthalmitis are coagulase-negative staphylococci, followed by Staphylococcus aureus, alpha-haemolytic streptococci, Pseudomonas and Streptococcus pneumoniae. 23 In another study, the most common bacteria isolated from preoperative conjunctival flora included Staphylococcus aureus, Staphylococcus epidermidis and Gram-negative bacteria, including Pseudomonas aeruginosa.…”

Section: Unmet Needs In the Postoperative Management Of Cataract Surgerymentioning

confidence: 99%

“…23 In Italy, the most diffuse bacteria causing postoperative endophthalmitis are coagulase-negative staphylococci, followed by Staphylococcus aureus, alpha-haemolytic streptococci, Pseudomonas and Streptococcus pneumoniae. 23 In another study, the most common bacteria isolated from preoperative conjunctival flora included Staphylococcus aureus, Staphylococcus epidermidis and Gram-negative bacteria, including Pseudomonas aeruginosa. 24 Among antibiotics, fluoroquinolones have a wide spectrum of action covering most of these pathogens (with the exception of coagulase-negative staphylococci); amphenicols (e.g.…”

Section: Unmet Needs In the Postoperative Management Of Cataract Surgerymentioning

confidence: 99%

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Current Challenges in the Postoperative Management of Cataract Surgery

Marchese¹,

Bandello²

2021

Ophthalmology

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Choosing wisely and the use of antibiotics in ophthalmic surgery: There is more than meets the eye

Abstract: Role of antibiotics is criticized in the light of stewardship antimicrobial paradigm.

Cited by 3 publications

References 79 publications

Emerging antimicrobial resistance and need for antimicrobial stewardship for ocular infections in India: A narrative review

Emerging antimicrobial resistance and need for antimicrobial stewardship for ocular infections in India: A narrative review

Intravitreal Injections during the COVID-19 Outbreak in Northern Italy: An Innovative Approach for a High Quality and Safe Treatment

Current Challenges in the Postoperative Management of Cataract Surgery

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