Survey of Intraocular Antibiotics Prophylaxis Practice after Open Globe Injury in China

Lou, Bingsheng; Lin, Lei; Tan, Junlian; Yang, Yao; Yuan, Zhihang; Lin, Xiaofeng

doi:10.1371/journal.pone.0156856

Cited by 5 publications

(6 citation statements)

References 35 publications

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“…[27][28][29] The benefit of intraocular antibiotics use was only observed in eyes with IOFB. [28][29][30] Using ceftazidime and vancomycin provides a good coverage against both gram-negative and gram-positive organisms, including methicillin-resistant Staphylococcus aureus. 27 Among the five cases of endophthalmitis suspected during operation in our study, one was a case of infection with B. cereus, and this case had a good visual outcome because intravitreal antibiotics were used at the time of initial treatment.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors of Postoperative Endophthalmitis After Primary Surgical Repair Combined With Intraocular Foreign Body Removal

Zhu

Tian

et al. 2022

Retina

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Purpose:To analyze the incidence and risk factors of postoperative endophthalmitis after primary surgical repair and intraocular foreign body (IOFB) removal within 24 hours of injury.Methods: The records of all patients treated surgically for open globe injury and IOFB removal at the Eye Hospital of Shandong First Medical University between January 1, 2015, and June 30, 2020, were retrospectively reviewed. Variables included time from injury to operation, cause of injury, details of surgical repair, and follow-up. The incidence and risk factors of endophthalmitis after IOFB removal were studied.Results: During 5 years, 99 patients with IOFB were reviewed. Of these, 19 patients were diagnosed with endophthalmitis on admission, and 5 were suspected of having endophthalmitis during operation. Fifty-four cases had no clinical signs of endophthalmitis on admission and during operation and were treated with operation within 24 hours after the injury. Two patients (2 of 54; 3.70%) developed endophthalmitis after IOFB removal, and the causative agent in both cases was Bacillus cereus. Conclusion:The incidence of infectious endophthalmitis after primary surgical repair combined with IOFB removal (#24 hours) was 3.70% in patients who received a series of standard treatments, and B. cereus infection might be a risk factor.

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Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors of Postoperative Endophthalmitis After Primary Surgical Repair Combined With Intraocular Foreign Body Removal

Zhu

Tian

et al. 2022

Retina

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“…In any infective condition, promptness and accuracy of antibiotic therapy play a very crucial role in salvaging organ function, more so in the microbial invasion of compartments like the eye. Thus, the choice of empirical antibiotics is important in endophthalmitis [ 9 , 10 ], while awaiting the laboratory results. It is well known that the spectrum of isolates is variable depending on the mode of inoculation.…”

Section: Discussionmentioning

confidence: 99%

“…In PCE, the spectrum is slightly different as Staphylococcus epidermidis , Staphylococcus aureus and Pseudomonas sp. are known to be common [ 7 , 10 , 12 ]. Mixed infections can also be seen in around 5% of cases [ 2 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile, Antibiotic Resistance and Outcomes in Bacterial Endophthalmitis: Coagulase-Negative Staphylococcus Endophthalmitis as Compared to Other Organisms

Gaur,

Takkar,

Chandra

et al. 2024

Cureus

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Background: To evaluate the clinical profile, outcomes and antibiotic resistance in bacterial endophthalmitis. Methods: This was a post-hoc analysis of a study conducted at a tertiary centre, where 60 consecutive cases of culture-proven bacterial endophthalmitis were included prospectively. Group 1 included coagulase-negative Staphylococcus endophthalmitis (CNSE), while group 2 included the remaining cases. Clinical features, antibiotic resistance and visual outcomes were compared. Visual acuity >3/60 at six months of follow-up was defined as a good visual outcome. Results: Group 1 had 31 cases, while group 2 had 29. Group 2 included 12 gram-positive and 17 gram-negative isolates. Among the groups, group 2 had more patients with presenting visual acuity below hand motions close to the face (25 vs. 12, p<0.001), poor visual outcomes (26 vs. 3, p<0.001) and retinal detachment (RD) (10 vs. 2, p=0.007). Pseudomonas was most commonly resistant to antibiotics, and ceftazidime (p=0.005) and cefazolin (p=0.009) resistance were higher in group 2 isolates. In group 1, five isolates were resistant to any one of the antibiotics, whereas in group 2, 13 isolates were resistant to any one of the antibiotics (p=0.024). Conclusions: In the current study, eyes in the group of endophthalmitis caused by CNSE achieved better visual acuities at the last follow-up compared to eyes with endophthalmitis caused by other bacteria. Antibiotic resistance in isolates other than CNSE is a cause of concern.

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“…Out of 153 (30.6%) participants who responded at a conference, 20.9% were routinely administered with a prophylactic intraocular injection of antibiotics which included intracameral (47.9%) and intravitreal (42.0%) injections. [ 15 ] More respondents from referral hospitals used intraocular injections (92.7%) compared to primary hospitals (69.4%) ( P = 0.001). [ 15 ] All eyes with posterior segment IOFBs received intravitreal antibiotics, and there were no cases of endophthalmitis after initial management in a study of IOFBs between 1999 and 2008 in Bascom Palmer Eye Institute.…”

Section: Why Is It Important To Do This Review?mentioning

confidence: 99%

“…[ 15 ] More respondents from referral hospitals used intraocular injections (92.7%) compared to primary hospitals (69.4%) ( P = 0.001). [ 15 ] All eyes with posterior segment IOFBs received intravitreal antibiotics, and there were no cases of endophthalmitis after initial management in a study of IOFBs between 1999 and 2008 in Bascom Palmer Eye Institute. [ 16 ] To the best of our knowledge, there has been no review anywhere in the literature on the effects of intravitreal antibiotics in the prevention of endophthalmitis in open globe injuries.…”

Section: Why Is It Important To Do This Review?mentioning

confidence: 99%

Role of intravitreal/intracameral antibiotics to prevent traumatic endophthalmitis – Meta-analysis

Thevi

Abas

2017

Indian J Ophthalmol

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Traumatic endophthalmitis is a devastating condition that can occur following an open globe injury and result in loss of vision. The use of prophylactic antibiotics is empirical as most surgeons fear complications associated with the same. No systematic review has been performed in English on the role of intravitreal/intracameral antibiotics in preventing traumatic endophthalmitis. We searched for randomized controlled trials and controlled clinical trials comparing intracameral/intravitreal antibiotics with placebos on PubMed, Google Scholar, Science Direct, and Cochrane Library using keywords open globe/trauma/penetrating/perforating injuries endophthalmitis. The last search was on 5 May 2017. We included patients of all ages with open globe injuries who received intracameral/intravitreal antibiotics, regardless of the dose. Quality of the trials was assessed using Cochrane collaboration tools to assess the risk of bias. The main outcome measures were endophthalmitis and visual acuity. We included three trials. Overall, intravitreal/intracameral antibiotics were noted to significantly reduce the occurrence of endophthalmitis in open globe injuries (relative risk [RR] 0.19, 95% confidence interval [CI] 0.06–0.57). The use of intravitreal/intracameral antibiotics did not have an effect in improving visual acuity (RR 1.17, 95% CI 0.61–2.23). Two trials (Narang 2003; Soheilan 2001) were observed to have no significant effect on visual acuity while another trial (Soheilan 2007) did not list visual acuity as part of its objectives. Intracameral/intravitreal antibiotics reduce the risk of endophthalmitis in open globe injuries; although, there was no improvement in the visual acuity. We, therefore, recommend the use of intravitreal/intracameral injections in open globe injuries to prevent this devastating complication.

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Survey of Intraocular Antibiotics Prophylaxis Practice after Open Globe Injury in China

Cited by 5 publications

References 35 publications

Incidence and Risk Factors of Postoperative Endophthalmitis After Primary Surgical Repair Combined With Intraocular Foreign Body Removal

Incidence and Risk Factors of Postoperative Endophthalmitis After Primary Surgical Repair Combined With Intraocular Foreign Body Removal

Clinical Profile, Antibiotic Resistance and Outcomes in Bacterial Endophthalmitis: Coagulase-Negative Staphylococcus Endophthalmitis as Compared to Other Organisms

Role of intravitreal/intracameral antibiotics to prevent traumatic endophthalmitis – Meta-analysis

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