Extensively drug-resistant Pseudomonas aeruginosa panophthalmitis from contaminated artificial tears

Wang, Taylor; Jain, Sumeet; Glidai, Yoav; Dua, Prachi; Dempsey, Katharine S.; Shakin, Eric; Chu, David S.; Epstein, Marcia; Ha, Lawrence G.

doi:10.1016/j.idcr.2023.e01839

Cited by 1 publication

(1 citation statement)

References 13 publications

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“…Nevertheless, certain gram-negative pathogens such as P. aeruginosa have developed resistance to broad-spectrum antibiotics, including fluoroquinolones, amikacin, and ceftazidime [ 8 , 56 ]. Notably, a recent multistate outbreak associated with drug-resistant Pseudomonas aeruginosa linked to artificial tears eye drops resulted in severe cases of keratitis, panophthalmitis, vision loss, and even enucleation and death [ 57 , 58 , 59 , 60 ]. Globally, reports have indicated a rising trend in resistance to fluoroquinolones and ceftazidime [ 61 , 62 , 63 ].…”

Section: Antimicrobial Resistance Associated With Endophthalmitismentioning

confidence: 99%

New Approaches to Overcoming Antimicrobial Resistance in Endophthalmitis

Garcia O’Farrill,

Abi Karam,

Villegas

et al. 2024

Pharmaceuticals

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Endophthalmitis is a rare but vision-threatening infection characterized by marked inflammation of intraocular fluids and tissues, uncommonly seen following surgery and intravitreal injection. Antimicrobials are used worldwide in the prophylaxis and treatment of bacterial and fungal infections of the eye and are standard treatment in the preoperative and postoperative care of surgical patients. However, antimicrobials are reported to be overprescribed in many parts of the world, which contributes to antimicrobial resistance (AMR). AMR complicates the prophylaxis and treatment of endophthalmitis. This article examines the prevalence and mechanisms of AMR in ocular microorganisms, emphasizing the importance of understanding AMR patterns for tailored treatments. It also explores prophylaxis and management strategies for endophthalmitis, with a discussion on the use of intracameral antibiotic administration. The use of prophylactic intracameral antibiotics during cataract surgery is common in many parts of the world but is still controversial in some locations, especially in the US. Finally, it highlights the role of stewardship in ophthalmology and its benefits in the treatment of endophthalmitis.

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