Cost comparison of commonly used postoperative topical ophthalmic antibiotics

Crowell, Eric L.; Koduri, Vivek A.; Groat, R. Scott; Lee, David A.

doi:10.1016/j.jcrs.2017.07.028

Cited by 9 publications

(7 citation statements)

References 11 publications

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“…In this line, a curious phenomenon of paradoxical bacterial survival has been described in the presence of extremely high levels of (45,87,88,90,101,461). In several cases, these findings have led to the discontinuation of research, withdrawal from clinical practice, and strong restrictions to specific nonsystemic applications (such as topical or ophthalmic), to serious life-or limb-threatening infections, or to last-resort applications, such as compassionate use of several of these quinolones (45,100,454,462,463). Note that these regulations may differ among different countries.…”

Section: Quinolone Resistance Mechanismsmentioning

confidence: 99%

Transferable Mechanisms of Quinolone Resistance from 1998 Onward

Ruiz

2019

Clin Microbiol Rev

115

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SUMMARY While the description of resistance to quinolones is almost as old as these antimicrobial agents themselves, transferable mechanisms of quinolone resistance (TMQR) remained absent from the scenario for more than 36 years, appearing first as sporadic events and afterward as epidemics. In 1998, the first TMQR was soundly described, that is, QnrA. The presence of QnrA was almost anecdotal for years, but in the middle of the first decade of the 21st century, there was an explosion of TMQR descriptions, which definitively changed the epidemiology of quinolone resistance. Currently, 3 different clinically relevant mechanisms of quinolone resistance are encoded within mobile elements: (i) target protection, which is mediated by 7 different families of Qnr (QnrA, QnrB, QnrC, QnrD, QnrE, QnrS, and QnrVC), which overall account for more than 100 recognized alleles; (ii) antibiotic efflux, which is mediated by 2 main transferable efflux pumps (QepA and OqxAB), which together account for more than 30 alleles, and a series of other efflux pumps (e.g., QacBIII), which at present have been sporadically described; and (iii) antibiotic modification, which is mediated by the enzymes AAC(6′)Ib-cr, from which different alleles have been claimed, as well as CrpP, a newly described phosphorylase.

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Section: Quinolone Resistance Mechanismsmentioning

confidence: 99%

Transferable Mechanisms of Quinolone Resistance from 1998 Onward

Ruiz

2019

Clin Microbiol Rev

115

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“…(17) The number of cataract surgery patient eyes needed to treat with NSAID to prevent 1 case of cystoid macular edema has been calculated at between 238 and 320. (18,19) The costs of topical drops, which may be hundreds of dollars (20), should be weighed against the benefit of the treatment, particularly when injectable agents provide superiority of treatment, or at the very least, are in equipoise.…”

Section: Anti-inflammatoriesmentioning

confidence: 99%

Drop-free approaches for cataract surgery

Shorstein

Myers

2020

Current Opinion in Ophthalmology

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“…Moreover, inappropriate use, especially overuse, corresponds to a substantial cost. It is reported that the cost of post-cataract surgery antibiotic use in 2016 in the U.S. was USD 170 million, and there is substantial opportunity to improve the value of care [ 8 ]. Hospital antimicrobial stewardship programs had been implemented and the appropriateness of antibiotic use was improved in recent years [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Trends in Outpatient Prescribing Patterns for Ocular Topical Anti-Infectives in Six Major Areas of China, 2013–2019

Zhu

Jin

et al. 2021

Antibiotics

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Topical anti-infectives are important in the management of ocular infections, but little is known about their current status and trends in their use in China. Thus, we carried out a prescription-based, cross-sectional study using the database of Hospital Prescription Analysis Projection of China, and aimed to analyze the trend in the use of ocular topical anti-infectives for outpatients of the ophthalmology department from 2013 to 2019. A total of 2,341,719 prescriptions from 61 hospitals located in six major areas written by ophthalmologists for outpatients were identified, and 1,002,254 of the prescriptions contained at least one anti-infective. The yearly anti-infective prescriptions increased continuously from 126,828 prescriptions in 2013 to 163,434 prescriptions in 2019. The cost also increased from 4,503,711 Chinese Yuan (CNY) in 2013 to CNY 5,860,945 in 2019. However, the use rate of anti-infectives decreased slightly from 46.5% in 2013 to 41.1% in 2019. Patients aged between 19 and 45 years old had the highest anti-infective use rate. Levofloxacin was the most frequently used anti-infective and kept on increasing among all age groups, occupying 67.1% of the total cost at the end of the study. Tobramycin was more frequently used in pediatric patients than in adults, but the use still decreased. Ganciclovir was the preferred anti-viral drug over acyclovir. In conclusion, the prescriptions and cost of ocular topical anti-infectives for outpatients both increased progressively. The increasingly widespread use of levofloxacin raised concerns regarding safety in pediatrics and resistance development. The observed trends can lead to the more efficient management of ocular anti-topical anti-infectives in China.

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Cost comparison of commonly used postoperative topical ophthalmic antibiotics

Cited by 9 publications

References 11 publications

Transferable Mechanisms of Quinolone Resistance from 1998 Onward

Transferable Mechanisms of Quinolone Resistance from 1998 Onward

Drop-free approaches for cataract surgery

Trends in Outpatient Prescribing Patterns for Ocular Topical Anti-Infectives in Six Major Areas of China, 2013–2019

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