Prophylactic antibiotics for ophthalmic surgery

Starr, Michael B.

doi:10.1016/0039-6257(83)90193-5

Cited by 90 publications

(26 citation statements)

References 79 publications

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“…Topical antibacterial agents are effective in reducing the local microbial population but require multiple applications (7,19). Of the antiseptic agents currently available for skin preparation, most are too toxic for direct instillation onto the ocular surface.…”

Section: Discussionmentioning

confidence: 99%

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Experimental evaluation of chlorhexidine gluconate for ocular antisepsis

Hamill¹,

Osato²,

Wilhelmus³

1984

Antimicrob Agents Chemother

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Chlorhexidine gluconate is a bisguanide germicide currently available with 70% isopropanol (Hibistat, Hibitane) or a detergent (Hibiclens, Hibiscrub) for preoperative skin preparation. As these solvents are toxic to the cornea, we investigated the safety and efficacy of aqueous chlorhexidine solutions for ophthalmic use. Chlorhexidine in Tris-glycine buffer was evaluated for retardation of epithelial regeneration after experimental corneal abrasion in rabbits. Irrigant concentrations of 2.0 and 4.0% chlorhexidine significantly slowed the healing rate (0.546 and 0.076 mm/h, respectively) compared with saline controls (0.938 mm/h). Irrigant concentrations of .l% did not statistically delay healing (P > 0.4). In a separate group of animals, the right conjunctivae of pigmented rabbits were inoculated with Staphylococcus epidermidis (_107 organisms per eye) and irrigated with 40 ,lI of aqueous chlorhexidine in concentrations of 0.1, 0.5, and 1.0%; the left eyes were irrigated with saline or left untreated. Quantitative conjunctival cultures were obtained, and the total number of organisms recovered per eye was calculated. All chlorhexidine-treated eyes showed significant reduction in organisms compared with either untreated or saline-irrigated control eyes (P < 0.001). In vitro antimicrobial susceptibility testing demonstrated chlorhexidine in concentrations of 0.1 to 4% to be highly active against a variety of gram-positive and gram-negative bacterial pathogens by disk diffusion and broth diffusion assays.

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Section: Discussionmentioning

confidence: 99%

“…Topical antibiotics have been suggested to reduce the conjunctival bacterial population (7,19), but there is no consensus regarding the optimal regimen. Unfortunately, most antiseptic agents such as povidone-iodine and hexachlorophene are toxic to the corneal epithelium (3,14).…”

mentioning

confidence: 99%

Experimental evaluation of chlorhexidine gluconate for ocular antisepsis

Hamill¹,

Osato²,

Wilhelmus³

1984

Antimicrob Agents Chemother

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show abstract

“…Entretanto, é descrito que a aplicação de antibióticos tópicos no pré-operatório, combinados ao uso do PVPI, é capaz de reduzir ainda mais a colonização bacteriana na conjuntiva (7) . Embora ainda não tenha sido determinada a dose, freqüên-cia, tempo e tipo de antibiótico tópico mais adequado para a profilaxia perioperatória, é aceito que estes são eficientes em reduzir a flora bacteriana da conjuntiva (7)(8)(9)(10)(11)(12) . A escolha do antibiótico a ser utilizado será influenciada por fatores como espectro de cobertura bacteriana, rapidez na eliminação das bactérias na superfície conjuntival, duração da ação, biodisponibilidade, toxicidade, padrões de susceptibilidade e custo (9)(10)(11) .…”

Section: Introductionunclassified