Prophylactic intracameral cefuroxime

Montan, Per; Wejde, Gisela; Koranyi, Gabor; Rylander, Margareta

doi:10.1016/s0886-3350(01)01269-x

Cited by 219 publications

(48 citation statements)

References 16 publications

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“…From the review of bibliographical references of the primary studies included and a manual search, three additional references were located. Therefore, seven references were finally included in this phase: one clinical trial reported in two papers,6,14 four observational studies,8,15–17 and an economic evaluation 18…”

Section: Resultsmentioning

confidence: 99%

“…The onset of endophthalmitis was 0.42% in the control group (period up to 2004), compared with 0.13% in the group that received cefuroxime (period between 2004 and 2007) ( P =0.031) (Table 1). A study performed in Sweden in 20028 with a similar design included two cohorts. The first one included 34,102 participants operated on for cataract between 1990 and 1995 without intracameral prophylaxis.…”

Section: Resultsmentioning

confidence: 99%

“…The administration of antibiotics in the anterior chamber after surgery is theoretically the most direct method for prophylaxis. Although its use has already been reported previously,8–10 it has been recently disseminated in Europe as a result of the multicenter, prospective, randomized controlled trial performed by the European Society of Cataract and Refractive Surgeons (ESCRS)6 using cefuroxime. In spite of the results of this pioneer study, we require further scientifically valid information on effectiveness, safety, and cost-effectiveness to guide us in decisions and potentially modify clinical practice in the quest for converging aims to improve health outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Intracameral cefuroxime and moxifloxacin used as endophthalmitis prophylaxis after cataract surgery: systematic review of effectiveness and cost-effectiveness

Linertová¹,

Abreu-González²,

García-Pérez³

et al. 2014

OPTH

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Postoperative endophthalmitis is one of the most serious potential complications of ocular lens surgery. Its incidence can be reduced by means of antibiotic prophylaxis. Although the prophylactic use of intracameral cefuroxime has been extended, other drugs, such as moxifloxacin, have arisen as alternatives. We performed a systematic literature review on the effectiveness and efficiency of intracameral cefuroxime and moxifloxacin for the prophylaxis of postoperative endophthalmitis after cataract surgery. Several bibliographic databases were searched up to October 2010 and were updated up to January 2013. Outcomes were the onset of endophthalmitis after surgery and the cost-effectiveness ratio of using both antibiotic prophylaxis alternatives. The following were included: a clinical trial reported in two papers, six observational studies, and an economic evaluation. All studies assessed cefuroxime compared with another antibiotic prophylaxis or no prophylaxis. The only randomized controlled trial performed by the European Society of Cataract and Refractive Surgery found that intracameral cefuroxime is significantly more effective than not using prophylaxis or the use of a topical antibiotic. The observational studies support these results. The economic evaluation compared different prophylaxis regimens and concluded that intracameral cefuroxime showed the best cost-effectiveness ratio. Both the observational studies and the economic evaluation have methodological limits that reduce their validity. This review confirmed that cefuroxime can prevent endophthalmitis after cataract surgery. Further randomized controlled trials, with large sample sizes, are required to compare different antibiotic prophylaxis regimens.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intracameral cefuroxime and moxifloxacin used as endophthalmitis prophylaxis after cataract surgery: systematic review of effectiveness and cost-effectiveness

Linertová¹,

Abreu-González²,

García-Pérez³

et al. 2014

OPTH

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“…In one of the studies regarding prophylaxis of endophthalmitis, Montan et al[ 9] reported that intracameral cefuroxime-axetil appeared to effectively inhibit sensitive bacterial strains and was associated with a low frequency of postoperative endophthalmitis. However, we had a high Gram-negative organism isolation rate (33.3%) with a low susceptibility rate for cefuroxime-axetil (12%).…”

Section: Discussionmentioning

confidence: 99%

Isolates and Antibiotic Sensitivity of Eighty Culture-Proven Endophthalmitis Cases from Istanbul

Eser¹,

Kapran²,

Altan³

et al. 2008

Ophthalmologica

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Purpose: To investigate the spectrum of organisms causing endophthalmitis and their sensitivity to commonly used antimicrobial agents. Methods: Medical records of 80 consecutive patients treated at Beyoglu Eye Hospital for endophthalmitis from January 2001 to April 2006 were reviewed. Specimens were obtained from either the vitreous (93%, 81/87) or anterior chamber (7%, 6/87) during pars plana vitrectomy or vitreous tap, and were inoculated into blood culture bottles. A Kirby-Bauer disk diffusion test was performed to determine antibiotic susceptibility. The outcome measures included isolates identified and antibiotic sensitivity of the specimens. Results: Fifty-six of 87 (64.4%) isolates were Gram-positive organisms, 29 (33.3%) were Gram-negative organisms, and 2 (2.3%) were fungi. The most common organism group identified was coagulase-negative staphylococci in 26.4% (23/87). While vancomycin was active against all Gram-positive isolates tested (100%), ceftazidime had the highest susceptibility rate (100%) for Gram-negative organisms isolated. Conclusions: Although coagulase-negative micrococci predominated in this series, a high isolation rate for Gram-negative organisms was obtained. High susceptibility rates for ofloxacin make it an alternative to ceftazidime and vancomycin in both Gram-negative- and Gram-positive-derived endophthalmitis, respectively. Studies with larger series and additional antibiotics are needed to confirm these findings.

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“…Although the effect of topical antibiotics in preventing bacterial postoperative endophthalmitis (POE) has been controversial [17,18,19], the prophylactic use of antibiotics before, during and/or after the operation is common. It was suggested that this treatment helps prevent bacterial POE by sterilizing the ocular surface and by penetrating the ocular tissues to provide intracameral antibiotic concentrations to eliminate bacteria that may enter the eye during surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Collagen Shields as a Drug Delivery System for the Fourth-Generation Fluoroquinolones

et al. 2006

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Purpose: To evaluate the penetration of commercially available gatifloxacin and moxifloxacin into the anterior chamber of a rabbit eye using collagen shields presoaked in the antibiotics as a drug delivery system. Methods: Collagen shields, presoaked for 10 min in commercially available solutions of gatifloxacin (diluted intravenous Tequin®) or moxifloxacin (Vigamox^TM) with the same concentration, were placed on the surface of each of the corneas of 12 rabbits for a total of 24 eyes (12 in each group). Aqueous humor samples were taken 3 and 6 h later. Results:The concentrations of both antibiotics were high after 3 h (3.1 ± 1.3 µg/ml for moxifloxacin and 2.3 ± 0.8 µg/ml for gatifloxacin, p = 0.22). The concentration of gatifloxacin after 6 h was statistically significantly higher than for moxifloxacin (0.76 ± 0.33 µg/ml vs. 0.29 + 0.14 µg/ml, respectively, p = 0.03). Conclusion: Our results suggest that collagen shields can be effective as a drug delivery system for the fourth-generation fluoroquinolones with a longer effect for gatifloxacin.

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Prophylactic intracameral cefuroxime

Cited by 219 publications

References 16 publications

Intracameral cefuroxime and moxifloxacin used as endophthalmitis prophylaxis after cataract surgery: systematic review of effectiveness and cost-effectiveness

Intracameral cefuroxime and moxifloxacin used as endophthalmitis prophylaxis after cataract surgery: systematic review of effectiveness and cost-effectiveness

Isolates and Antibiotic Sensitivity of Eighty Culture-Proven Endophthalmitis Cases from Istanbul

Collagen Shields as a Drug Delivery System for the Fourth-Generation Fluoroquinolones

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