Systemic Antibiotic Prophylaxis in Penetrating Ocular Injuries

Dv, Alfaro; Pince, Keith J.; Park, J; Runyan, Todd; Sj, Ryan; Pe, Liggett

doi:10.1097/00006982-199212031-00002

Cited by 15 publications

(9 citation statements)

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“…However, since the choice of antibiotic and the route of administration in our population varied greatly according to the treating physician, this clinical observation should be looked at cautiously. Indeed, various antibiotics have been shown to have different intravitreal penetration when given intravenously in experimental models [23][24][25][26]. The previously noted low incidence of posttraumatic infection in our pediatric population is consistent with a previous report from Kuwait [15] and other studies [10,14,20,27].…”

Section: Discussionsupporting

confidence: 88%

Open Eye Injuries in the Pediatric Population in Kuwait

et al. 2002

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Objective: To report the epidemiological characteristics of pediatric open globe injuries and to discuss treatment, management and outcomes of such injuries. Materials and Method: The hospital records and operative notes of 95 patients 16 years old and younger who were treated for open eye injury at Ibn Sina Hospital, Kuwait between September 1995 and January 1999 were reviewed. The average age of patients was 6.6 years. Patients were divided into three groups according to their final visual acuity (FVA): group 1, FVA of 20/40 or better; group 2, 20/40–20/200, and group 3, 20/400 or worse. The FVA of each group was compared to initial visual acuity (IVA), wound entry site, injury-to-presentation interval, injury-to-surgery interval, time of surgery, duration of surgery, associated injuries and medical treatment. Results: Injury was most common in children 3–6 years old. Most injuries occurred during play at home (46%), between the months of July and November (58%), and evening time (42%). The most common causes were glass, pencil, stick, soft drink bottle, metal bar, and stone. The cornea was the most common entry site (59 cases). Seventy-three patients presented on the day of injury, and 38 of them had surgical repair that same day. The follow-up period ranged from 2 weeks to 58 months. Thirty-eight patients (40%) had an FVA of 20/40 or better (group 1), 23 (24%) between 20/40 and 20/200 (group 2), 12 (13%) 20/400 or worse (group 3), and 22 (23%) had no record of FVA. The difference between IVA and FVA of wound entry site was statistically significant (p < 0.005). Differences due to injury-to-presentation interval, injury-to-surgery interval, time of surgery, duration of surgery, associated injuries, and the use of systemic antibiotics were found not to be statistically significant (p > 0.2). Conclusion: The prevalence of open globe injury among the pediatric population in Kuwait was high. Most injuries were due to household objects and occurred at home in the evening during the summer and autumn. IVA and anatomical location of the wound impacted on final outcome.

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Section: Discussionsupporting

confidence: 88%

Open Eye Injuries in the Pediatric Population in Kuwait

et al. 2002

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“…Gentamicin, based in susceptibilities from Table 3, does have excellent gram-positive bacilli (100%) and gram-negative organism (92.0%) susceptibilities along with adequate gram-positive cocci susceptibilities (81.5%) on cultured organisms. Models of intraocular penetration of intravenous gentamicin have been performed in rabbits that, while demonstrating increased penetration to the vitreous of eyes with penetrating trauma compared with normal eyes, did not reach a minimum inhibitory concentration (MIC) value needed for most organisms 42. This result was repeated in pig eyes with similar findings that intravenous gentamicin did not reach MIC for Pseudomonas or Haemophilus sp 43.…”

Section: Antimicrobial Therapymentioning

confidence: 96%

Infectious Disease Prevention and Management in Traumatic Open Globe Injuries

Weinert¹,

Armstrong²

2022

International Ophthalmology Clinics

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“…22 In a study by Gregor and Ryan, 23 the competence of the bloodretinal barrier at the level of the retinal pigment epithelium was studied at 30 minutes, 3 days, and 7 days after experimental blunt eye injuries in pig. Leakage of injected horseradish peroxidase was seen at the level of the retinal pigment epithelium within the first 3 days after injury, but not 7 days after injury.…”

Section: Oral Antibioticsmentioning

confidence: 99%

Prophylactic Antibiotics in Posttraumatic Infectious Endophthalmitis

Lorch¹,

Sobrin²

2013

International Ophthalmology Clinics

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Endophthalmitis is a feared complication of any intraocular surgery but is of particular concern after the repair of open globe injury. Reported rates of endophthalmitis in open globe injury are higher than for intraocular surgery, presumably because of nonsterile conditions at the time of an injury. 1 Rates of posttraumatic endophthalmitis vary; in a review of 558 patients with open globes, Andreoli et al 2 found a rate of 0.9% of endophthalmitis, whereas Verbraeken and Rysselaere 3 found a rate of 4% in 615 patients, Ariyasu et al 4 found a rate of 7.2% in 670 open globe patients, and Essex et al 5 found a rate of 6.8% in 250 patients. The rate of endophthalmitis after intraocular surgery, by comparison, is approximately 0.001%. 1 In addition to suffering from higher endophthalmitis rates, patients with posttraumatic endophthalmitis have worse postoperative outcomes than patients with postoperative endophthalmitis. 6 In a study of 25 patients with endophthalmitis, Verbraeken and Rysselaere 3 found only 38% to recover functional vision (light perception or better), compared with 60% of postoperative endophthalmitis patients resulting in functional vision in a previous study by the same author.The discrepancy in endophthalmitis rates in patients after open globe repair may be attributed to variable risk factors for endophthalmitis based on patient population but also to variable antibiotic prophylactic regimens.Despite extensive literature on open globe injuries and outcomes, there have been no randomized controlled studies to establish the best prophylactic antibiotic regimen and there is no standard protocol. This review attempts to summarize the antibiotic regimens that have been used for these patients and present the current thought in appropriate

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Systemic Antibiotic Prophylaxis in Penetrating Ocular Injuries

Cited by 15 publications

References 0 publications

Open Eye Injuries in the Pediatric Population in Kuwait

Open Eye Injuries in the Pediatric Population in Kuwait

Infectious Disease Prevention and Management in Traumatic Open Globe Injuries

Prophylactic Antibiotics in Posttraumatic Infectious Endophthalmitis

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