Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde · 2020
Management of Endophthalmitis with and without Topical Antibiotics: A Case-Control Study.
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Dave Vivek Pravin, Pathengay Avinash, Nishant Kumar, Reddy Venkata Shubakar, Pappuru Rajeev Reddy, Das Taraprasad
Аннотация
PURPOSE: The aim of this study was to compare the management outcome of endophthalmitis with and without the use of topical antibiotics.
METHODS: A retrospective comparative chart review of 2 cohorts of endophthalmitis (other than those associated with open-globe injury, keratitis, or wound site infection), one managed with topical antibiotics (TA group) and one without (NTA group), was performed.
RESULTS: The study included a total of 270 eyes of 270 patients. Of these, 169 eyes were in the TA group and 101 were in the NTA group. Post-cataract surgery was the most common etiology, accounting for 81.06 and 78.2% of cases, respectively (p = 0.57). A favorable functional outcome at the last visit was seen in 37.5 and 39.6% of eyes (p = 0.73), and a favorable anatomic outcome was noted in 61.2 and 49.5% of eyes (p = 0.06), respectively. The median follow-up was 3.5 and 9 months, respectively (p < 0.0001). Susceptibilities to the common antibiotics used (vancomycin, ceftazidime, and amikacin) were comparable, with the exception of imipenem, for which the susceptibility noted was 95 and 66%, respectively (p = 0.01). Culture positivity in the TA group was seen in 72 out of 169 eyes (42.6%), while in the NTA group it was seen in 98 out of 101 eyes (97.02%; p < 0.0001).
CONCLUSION: Topical antibiotics do not give any added advantage in the management of endophthalmitis otherwise being treated with intravitreal antibiotics and standard vitrectomy techniques.
METHODS: A retrospective comparative chart review of 2 cohorts of endophthalmitis (other than those associated with open-globe injury, keratitis, or wound site infection), one managed with topical antibiotics (TA group) and one without (NTA group), was performed.
RESULTS: The study included a total of 270 eyes of 270 patients. Of these, 169 eyes were in the TA group and 101 were in the NTA group. Post-cataract surgery was the most common etiology, accounting for 81.06 and 78.2% of cases, respectively (p = 0.57). A favorable functional outcome at the last visit was seen in 37.5 and 39.6% of eyes (p = 0.73), and a favorable anatomic outcome was noted in 61.2 and 49.5% of eyes (p = 0.06), respectively. The median follow-up was 3.5 and 9 months, respectively (p < 0.0001). Susceptibilities to the common antibiotics used (vancomycin, ceftazidime, and amikacin) were comparable, with the exception of imipenem, for which the susceptibility noted was 95 and 66%, respectively (p = 0.01). Culture positivity in the TA group was seen in 72 out of 169 eyes (42.6%), while in the NTA group it was seen in 98 out of 101 eyes (97.02%; p < 0.0001).
CONCLUSION: Topical antibiotics do not give any added advantage in the management of endophthalmitis otherwise being treated with intravitreal antibiotics and standard vitrectomy techniques.