Incidence of endophthalmitis and impact of prophylaxis with cefuroxime on cataract surgery

Rodríguez-Caravaca, Gil; García-Sáenz, Ma Carmen; Villar-del-Campo, Ma Concepción; Andrés-Alba, Yolanda; Arias-Puente, Alfonso

doi:10.1016/j.jcrs.2013.03.031

Cited by 60 publications

(38 citation statements)

References 11 publications

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“…[4][5][6][7][8][9][10][11][12] Both the 2011 American Academy of Ophthalmology (AAO) Cataract Preferred Practice Pattern Guidelines and a 2011 ASCRS Cataract Clinical Committee review of endophthalmitis prevention noted that there was stronger evidence supporting direct intracameral injection than for any other method of antibiotic prophylaxis. 13,14 In 2013, 15 the ESCRS published endophthalmitis prophylaxis guidelines that reviewed the evidence supporting the safety and efficacy of direct intracameral injection of cefuroxime.…”

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confidence: 99%

Antibiotic prophylaxis of postoperative endophthalmitis after cataract surgery: Results of the 2014 ASCRS member survey

Chang¹,

Braga-Mele²,

Henderson³

et al. 2015

Journal of Cataract and Refractive Surgery

148

126

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A 2014 online survey of the American Society of Cataract and Refractive Surgery members indicated increasing use of intracameral antibiotic injection prophylaxis compared with a comparable survey from 2007. Forty-seven percent of respondents already used or planned to adopt this measure. One half of all surgeons not using intracameral prophylaxis expressed concern about the risks of noncommercially prepared antibiotic preparations. Overall, the large majority (75%) said they believe it is important to have a commercially available antibiotic approved for intracameral injection. Assuming reasonable cost, the survey indicates that commercial availability of Aprokam (cefuroxime) would increase the overall percentage of surgeons using intracameral antibiotic injection prophylaxis to nearly 84%. Although the majority used topical perioperative antibiotic prophylaxis, and gatifloxacin and moxifloxacin were still the most popular agents, there was a trend toward declining use of fourth-generation fluoroquinolones (60%, down from 81% in 2007) and greater use of topical ofloxacin and ciprofloxacin (21%, up from 9% in 2007).

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mentioning

confidence: 99%

Antibiotic prophylaxis of postoperative endophthalmitis after cataract surgery: Results of the 2014 ASCRS member survey

Chang¹,

Braga-Mele²,

Henderson³

et al. 2015

Journal of Cataract and Refractive Surgery

148

126

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“…54 It has been shown that using intracameral cefuroxime prevents 1 case of endophthalmitis for every 182 patients treated, thus providing a very favourable outcome in terms of the healthcare budget. 55 Although the use of intracameral cefuroxime has become a standard of care in the European countries, it is far from fully recognized worldwide. Outside Europe, only 2 studies (USA and South Africa) have reported significantly lower rates of postoperative endophthalmitis with the use of prophylactic intracameral cefuroxime.…”

Section: Intracameral Antibioticsmentioning

confidence: 99%

A Review of Antibiotic Prophylaxis for Post-operative Endophthalmitis

Goray¹

2016

DJO

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“…Zahlreiche weitere Studien, in welchen die Inzidenzen postoperativer Endophthalmitiden vor und nach Einführung der intracameralen Antibiotika-Prophylaxe mittlerweile untersucht wurden, belegen ebenfalls den hohen Stellenwert dieser prophylaktischen Maß-nahme [9][10][11][12].…”

Section: Prophylaxeunclassified

Prophylaxe und Therapie der akuten postoperativen Endophthalmitis nach Kataraktoperation – state of the art

Egger

2016

Spektrum Augenheilkd.

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ZusammenfassungHintergrund Die Inzidenz der akuten postoperativen Endophthalmitis konnte durch verbesserte Operationstechniken und perioperative Regime in den letzten Jahrzehnten deutlich reduziert werden, dennoch stellt die Erkrankung nach wie vor eine das Sehvermögen massiv bedrohende postoperative Komplikation dar. Die derzeit -Evidenz basiert -optimalen perioperativen und therapeutischen Regime werden erläutert. Resultate Die Inzidenz der akuten postoperativen Endophthalmitis kann nach sorgfältiger präoperativer Antisepsis (Polyvidon-Jod 5 % in den Bindehautsack) und der unmittelbar am Ende der OP erfolgenden Instillation von 0,1 ml Curocef (1 mg/0,1 ml) in die Vorderkammer des Auge hochsignifikant reduziert werden. Bei Auftreten einer akuten postoperativen Endophthalmitis ist die rasche intravitreale Antibiotika Instillation von entscheidender Bedeutung. Die Therapie der Wahl besteht in der intravitrealen Applikation von Vancomycin (1 mg/0,1 ml) und Ceftazidim (2 mg/0,1 ml). Prophylaxis and therapy of acute postoperative endophthalmitis after cataract extraction -state of the art SummaryBackground Cataract extraction is one of the most frequently performed surgical procedures in medicine. Incidence could be lowered over the last decades due to advances in operation techniques and perioperative regimes. However, acute postoperative endophthalmitis still remains a vision threatening disease. The up to now best -evidence based -perioperative regime to prevent the disease and recommended therapy will be discussed. Results The incidence of acute postoperative endophthalmitis can be significantly decreased by the instillation of 0.1 ml cefuroxime (1 mg/0.1 ml) into the anterior chamber at the end of the cataract operation. Acute postoperative endophthalmitis should be treated immediately by performing an intravitreal injection of vancomycin (1 mg/0.1 ml) as well as ceftazidime (2 mg/0.1 ml) and -if possible -vitrectomy. Conclusions An efficient perioperative regimen offers the possibility to decrease the incidence of acute postoperative endophthalmitis significantly. If necessary, treatment should be initiated immediately, so an improvement of visual acuity can be accomplished in many cases.

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Incidence of endophthalmitis and impact of prophylaxis with cefuroxime on cataract surgery

Abstract: Intracameral cefuroxime reduced the incidence of endophthalmitis in cataract surgery and had a high clinical and economic impact on its prevention.

Cited by 60 publications

References 11 publications

Antibiotic prophylaxis of postoperative endophthalmitis after cataract surgery: Results of the 2014 ASCRS member survey

Antibiotic prophylaxis of postoperative endophthalmitis after cataract surgery: Results of the 2014 ASCRS member survey

A Review of Antibiotic Prophylaxis for Post-operative Endophthalmitis

Prophylaxe und Therapie der akuten postoperativen Endophthalmitis nach Kataraktoperation – state of the art

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