Re: Schwartz et al.: Intracameral antibiotics and cataract surgery: endophthalmitis rates, cost, and stewardship ( Ophthalmology . 2016;123:1411-1413)

Ambati, Balamurali K.

doi:10.1016/j.ophtha.2016.08.033

Cited by 1 publication

(1 citation statement)

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“…The authors further extrapolated to show a financial cost of about USD 250 000 per additional case prevented, assuming $100 per dose of an unspecified intracameral antibiotic [36]. However, counterarguments to this conclusion argued that intracameral moxifloxacin can cost as low as $8.72 per dose and intracameral cefuroxime and vancomycin can cost as low as $1 per dose [37]. Radish et al [38] showcased a cost reduction of intracameral moxifloxacin from $140 to $20 per surgery after the implementation of a centralized production process of intracameral moxifloxacin.…”

Section: Considerations Of Cost-benefitmentioning

confidence: 99%

Intracameral antibiotics during cataract surgery: efficacy, safety, and cost–benefit considerations

Lieu,

Jun,

Afshari

2023

Current Opinion in Ophthalmology

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Purpose of review We summarize evidence-based considerations regarding the use of intracameral antibiotics during cataract surgery. Recent findings The use of intraoperative intracameral antibiotics reduced the incidence of postcataract surgery endophthalmitis 3.5-fold, with an odds ratio ranging from 0.14 to 0.19. A survey of the American Society of Cataract and Refractive Surgery showed usage of intracameral injections of antibiotics increased by 16% in the United States between 2014 and 2021. The frequency of vancomycin usage has sharply dropped to 6%, while moxifloxacin is now the dominant choice at 83% among respondents. One analysis showed that 2500 patients need to be treated with intracameral antibiotics to prevent one case of endophthalmitis. A 500 μg intracameral moxifloxacin at $22 dollars per dose is cost-effective, including for patients with posterior capsular rupture (PCR). Summary Studies substantiate the safety and efficacy of intracameral antibiotics for endophthalmitis prophylaxis. Intracameral moxifloxacin and cefuroxime are the most common choices. While vancomycin shows potential for efficacy, further studies evaluating clinical outcomes are needed. Adverse events are rare and commonly due to errors in preparation. Topical antibiotics do not provide additional prophylactic benefits to intracameral regimens. Intracameral antibiotics given alone are cost-effective.

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Section: Considerations Of Cost-benefitmentioning

confidence: 99%