Ocular flora in patients undergoing intravitreal injections: antibiotic resistance patterns and susceptibility to antiseptic picloxydine

Budzinskaya, M.V.

doi:10.18240/ijo.2020.01.13

Cited by 12 publications

(5 citation statements)

References 25 publications

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“…In recent years the role of antibiotic resistance has become an important issue, not only in ophthalmology but in all fields of medicine. In fact, the routine adoption of antibiotics for infection prophylaxis during multiple IVT courses has been associated with an increased risk of developing antibiotic resistance in the conjunctival flora [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a New Commercial Ocular Spray Containing Oftasecur Citrus Extract for Reducing Microbial Load in the Conjunctiva of Patients Receiving Intravitreal Injections

et al. 2021

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Introduction: The control of conjunctival microbial load is crucial for patients receiving intravitreal injections (IVTs) in order to reduce the risk of endophthalmitis. The purpose of this work was to assess the antimicrobial activity of a new commercial ocular spray containing Biosecur citrus extract (Oftasecur Ò , Off Health, Florence, Italy). Methods: This prospective cross-sectional pilot study included patients receiving IVTs who were instructed to apply Oftasecur spray onto the eye to be injected four times daily starting 4 days before surgery. The contralateral eye was considered the control. A conjunctival swab for microbiological analysis was performed in both eyes before starting study treatment and at the time of the injection. The Brief Ocular Discomfort Inventory (BODI) questionnaire was administered to patients based on an 11-point scale (0 for no discomfort and 10 for maximum discomfort). Results: Thirty patients (15 male, 15 female; mean age 64.7 ± 11.6 [standard deviation, SD] years) were included. Before starting treatment, 53.3% of the total eyes tested positive during

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Section: Discussionmentioning

confidence: 99%

Efficacy of a New Commercial Ocular Spray Containing Oftasecur Citrus Extract for Reducing Microbial Load in the Conjunctiva of Patients Receiving Intravitreal Injections

et al. 2021

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“…In their study, Budzinskaya et al have given a prophylactic topical aminoglycoside antibiotic (tobramycin) in 20 patients for 8 days following intravitreal injections. 10 Tobramycin administration was associated with a 4.5-fold increase in conjunctival bacterial resistance (from 20% to 90%) among conjunctival staphylococci.…”

Section: Discussionmentioning

confidence: 97%

“…However, no study supports the use of topical antibiotics in this indication and a body of evidence shows that acquired bacterial resistance is promoted by inadequate antibiotic prescription. 10 To our knowledge, no study has compared the effect of antiseptics and antibiotics on the management of CFBs.…”

Section: Introductionmentioning

confidence: 99%

Corneal foreign bodies: are antiseptics and antibiotics equally effective?

Rebattu

Baillif

Ferrete

et al. 2023

Eye

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To compare the effect of antiseptics and antibiotics on the occurrence of Infectious Keratitis (IK) secondary to Corneal Foreign Body (CFB) removal. MethodsMulticenter retrospective study conducted between June 2020 and June 2022 in patients referred for CFBs and treated with Picloxydine (Group 1) or Tobramycin (Group 2) for 7 days. A follow-up visit was scheduled on Day 3 (D3) and a phone call on D30. The primary outcome measure was the occurrence of IK. Results307 patients (300 men) with a mean age of 42.8 (14.8) years were included. The mean (SD) time to consultation was 43.1 (45.6) hours. Picloxydine and Tobramycin were given to 155 and 152 patients. Half of patients (n = 154, 50.2%) were building workers and 209 (68.1%) did not wear eye protections. CFBs were mainly metallic (n = 292, 95.1%). Upon referral, rust was found in 220 patients (72.1%). A burr was used in 119 (38.9%) patients. IK occurred in 15 (4.9%) patients, 8 (5.3%) in Group 1 and 7 (4.5%) in Group 2 (p = 0.797). IK was successfully treated in all cases. Persistent rust was found in 113 patients (36.9%) on D3 without difference between burr or needle use (p = 0.278). On D3, corneal healing was delayed in 154 patients (47.2%), mainly in burr-treated patients (p = 0.003). The mean (SD) work stoppage duration was 0.32 (0.98) days. ConclusionIK rate was 4.9%. The e cacy of antibiotics and antiseptics was similar on CFB removal. Using a burr was associated with a longer healing time. CFBs had a limited social impact.

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“…In a clinical research by Budzinskaya et al . [ 14 ] in 2020 on antibiotic susceptibility patterns of ocular flora in patients undergoing IVI, they stated that conjunctival flora of patients who received 20 or more IVI along with prophylactic antibiotics showed resistance to a wide range of antibiotics. A study by Miller et al .…”

Section: Discussionmentioning

confidence: 99%

Impact of topical moxifloxacin prophylaxis and povidone iodine on conjunctival bacterial flora in patients receiving intravitreal injections in a tertiary healthcare center in India

Sahu

Priya

Aggarwal

2022

J Family Med Prim Care

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Purpose: To assess the efficacy of 3 days of topical moxifloxacin in combination with povidone–iodine (PVI) versus moxifloxacin/PVI alone in eliminating conjunctival bacterial flora in patients scheduled to undergo intravitreal injections (IVI). Patients and Methods: A prospective randomized comparative study in which 120 patients scheduled to undergo IVI at a tertiary care hospital in New Delhi were selected. Study patients were randomized into two groups. Both the groups received self-administration of moxifloxacin for 3 days prior to injection, except in Group B where it was preceded by PVI. Cultures were obtained at different time intervals, such as in Group A before and after applying moxifloxacin (for 3 days) and once again after applying PVI just before the procedure in the operating room, whereas in Group B first two samples were taken before and after applying PVI and the last sample was taken on the day of the procedure after 3 days of moxifloxacin application. Results: A statistical significance was seen between moxifloxacin prophylaxis and resistant coagulase-negative Staphylococcus (CoNS) ( P = 0.0001), which implies that frequent use of antibiotic prophylaxis will ultimately lead to the formation of resistant organisms in the conjunctival flora, especially when repeated IVI are given. Conclusion: We could not establish any additional benefits of topical moxifloxacin prophylaxis with regard to a reduction in conjunctival flora when compared with PVI 5%. PVI can be used as an efficient monotherapy in patients undergoing repeated IVI.

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Ocular flora in patients undergoing intravitreal injections: antibiotic resistance patterns and susceptibility to antiseptic picloxydine

Cited by 12 publications

References 25 publications

Efficacy of a New Commercial Ocular Spray Containing Oftasecur Citrus Extract for Reducing Microbial Load in the Conjunctiva of Patients Receiving Intravitreal Injections

Efficacy of a New Commercial Ocular Spray Containing Oftasecur Citrus Extract for Reducing Microbial Load in the Conjunctiva of Patients Receiving Intravitreal Injections

Corneal foreign bodies: are antiseptics and antibiotics equally effective?

Impact of topical moxifloxacin prophylaxis and povidone iodine on conjunctival bacterial flora in patients receiving intravitreal injections in a tertiary healthcare center in India

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