Alternative Intravitreal Antibiotics

Abstract

Purpose: To organize, categorize, and create a quick reference guide for the use of intravitreal antibiotic alternatives to the standard combination of vancomycin and ceftazidime for the treatment of endophthalmitis.Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. The authors searched for all available information regarding intravitreal antibiotics in the last 21 years. Manuscripts were selected according to relevance, level of information, and the available data regarding intravitreal dose, potential adverse effects, bacterial coverage, and relevant pharmacokinetic information.Results: The authors included 164 of 1810 manuscripts. The antibiotics were classified according to their class into fluoroquinolones, cephalosporins, glycopeptide and lipopeptide, penicillins and beta-lactams, tetracyclines, and miscellaneous. The authors also included information regarding intravitreal adjuvants for the treatment of endophthalmitis and one ocular antiseptic. Conclusion:The treatment of infectious endophthalmitis is a therapeutic challenge. The current review summarizes the properties of possible intravitreal antibiotic alternatives that should be considered in cases of suboptimal response to initial treatment.

Clinical Features, Antibiotic Susceptibilities, and Outcomes of Endophthalmitis Caused by Streptococcal Infection: Children vs. Adults

“…Endophthalmitis is a severe vision-threatening ocular infection resulting from the intraocular colonization of microorganisms and is defined as an ophthalmic emergency owing to its potential for significant visual morbidity and sequelae [ 1 ]. Therefore, endophthalmitis treatment is a therapeutic challenge [ 2 ].…”

“…In the present study, we reviewed a relatively large sample of 67 cases of streptococcal endophthalmitis with the following aims: (1) to describe the microorganism profile, etiology, and sensitive antibiotics for streptococcal endophthalmitis; (2) to analyze the changing trend in the incidence and microorganism profile and compare the differences between adults and children; and (3) to describe the treatment strategy and analyze visual outcomes. Our findings provide important data that can guide the future management of these sight-threatening conditions.…”