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Endophthalmitis after cataract surgery and effect of different intracameral antibiotic regimes in Sweden 2011-2017: national registry study.
Friling, Emma; Bro, Tomas; Lundström, Mats; Montan, Per.
Afiliación
  • Friling E; From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Friling, Montan); Capio Medocular, Specialistläkarhuset, Sundsvall, Sweden (Friling); Department of Ophthalmology, Umeå University Hospital, Umeå, Sweden (Friling); Memira Eye Center, Jönköping, Sweden (Bro); Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden (Bro); Department of Clinical Sciences, Ophthalmology, Faculty of Medicine, Lund University, Lund, Sweden (Lundströ
J Cataract Refract Surg ; 50(8): 828-835, 2024 Aug 01.
Article en En | MEDLINE | ID: mdl-38661497
ABSTRACT

PURPOSE:

To study the incidence, predictive factors, etiology, and visual consequences of postoperative endophthalmitis (PE) in relation to 3 intracameral (IC) antibiotic regimes.

SETTING:

Swedish National Cataract Register entries from 2011 through 2017.

DESIGN:

Observational retrospective study.

METHODS:

PE incidence, influencing factors, bacteriology, and visual outcome were analyzed regarding the 3 major prophylactic IC protocols.

RESULTS:

The overall incidence of PE was 0.023% or 177 cases in 764 513 cataract procedures. Analyzed per IC regime, the rates of PE were 0.024% (126 cases in 514 916 surgeries) for cefuroxime, 0.020% (25 cases in 122 340 surgeries) for moxifloxacin, and 0.017% (20 cases in 121 045 surgeries) for combined cefuroxime-ampicillin. Incidences were not statistically significantly different from one another. Gram-positive bacteria caused 89.0% of culture positive cases. Enterococci as pathogens were significantly more frequent with IC cefuroxime than with moxifloxacin, P = .006, or cefuroxime-ampicillin, P < .001, while streptococci other than enterococci were more common with moxifloxacin than with cefuroxime, P < .001. Bacterial susceptibility to the given antibiotics was demonstrated in 21.3% of PE cases treated with cefuroxime, which was statistically significantly lower than proportions found with cefuroxime-ampicillin, 60.0%, P = .015, or with moxifloxacin, 88.2%, P < .001. Visual outcome worse than 20/200 was similar in the groups ranging from 42.0% to 53.7%.

CONCLUSIONS:

No statistically significant differences in PE incidence or visual outcome results between treatment groups were demonstrated. However, differences in etiology and bacterial sensitivity were found between the prophylactic IC treatments.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Extracción de Catarata / Infecciones Bacterianas del Ojo / Sistema de Registros / Endoftalmitis / Antibacterianos Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Cataract Refract Surg Asunto de la revista: OFTALMOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Extracción de Catarata / Infecciones Bacterianas del Ojo / Sistema de Registros / Endoftalmitis / Antibacterianos Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Cataract Refract Surg Asunto de la revista: OFTALMOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos