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Antibiotic prophylaxis: different practice patterns within and outside the United States

Authors Schwartz S, Grzybowski A, Flynn Jr. H

Received 12 November 2015

Accepted for publication 3 December 2015

Published 28 January 2016 Volume 2016:10 Pages 251—256


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Stephen G Schwartz,1 Andrzej Grzybowski,2 Harry W Flynn Jr1

1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Ophthalmology, Poznan City Hospital, Poznan, Poland

Abstract: Endophthalmitis remains a rare but important cause of visual loss. Prophylaxis strategies are important to reduce rates of endophthalmitis after cataract surgery, intravitreal injection, and other procedures. There is substantial variability between the US and the rest of the world. During cataract surgery, intracameral antibiotics are commonly used in many nations, especially in Europe, but are less commonly used in the US. A randomized clinical trial from the European Society of Cataract and Refractive Surgeons reported an approximately fivefold reduction in endophthalmitis rates associated with intracameral cefuroxime but these results are controversial. There are no randomized clinical trials regarding endophthalmitis associated with intravitreal injection. Topical antibiotics are commonly used in many nations, but are less commonly used in the US. At this time, there is no global consensus and it appears unlikely that additional major clinical trials will conclusively define the optimal endophthalmitis prophylaxis techniques.

Keywords: cataract surgery, endophthalmitis, intracameral antibiotic, intravitreal injection, prophylaxis

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