Infectious postoperative endophthalmitis after cataract surgery performed over 7 years. The role of azithromycin versus ciprofloxacin eye drops
Tuñí-Picado, Josep (Hospital de la Esperanza (Barcelona). Departament d'Oftalmologia)
Martínez-Palmer, Ana (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Fernández-Sala, Xènia (Hospital del Mar (Barcelona, Catalunya))
Barceló-Vidal, Jaime (Hospital del Mar (Barcelona, Catalunya))
Castilla Marti, Miguel (Hospital de la Esperanza (Barcelona). Departament d'Oftalmologia)
Cartagena-Guardado, Yasmin (Hospital de la Esperanza (Barcelona). Departament d'Oftalmologia)
Grau, Santiago (Universitat Autònoma de Barcelona. Departament de Farmacologia, de Terapèutica i de Toxicologia)

Date:	2018
Abstract:	Although topical antibiotics have been used as antimicrobial prophylaxis after ocular surgery, recent studies have determined that intracameral cefuroxime at the end of surgery significantly reduce the risk to suffer an infection and suggest that the use of topical antibiotics in the prophylaxis of infectious postoperative endophthalmitis (IPOE) is controversial. Moreover, there is no evidence to confirm the higher effectiveness of topical ciprofloxacin, considered the standard of care, or topical azithromycin in preventing IPOE of cataract surgeries. IPOE topical prophylaxis was performed with two different strategies: with azithromycin from January 1st, 2010 to December 31st, 2014 (group I) and with ciprofloxacin from January 1st, 2015 to January 31st, 2017 (group II). Patient characteristics and clinical signs and symptoms of IPOE from all consecutive cataract surgeries performed over a 7-year period were collected. A total of 15,146 cataract surgeries were conducted; 10,756 in group I and 4,390 in group II. Two cases of IPOE in each group were diagnosed, showing a 0. 019% and 0. 046% rate respectively, with no statistically significance. IPOE cases were related with aging, systemic and ocular comorbidities or with a complicated cataract surgery. The benefit of the application of topical antibiotics after cataract surgery is questionable when intracameral cefuroxime prophylaxis is performed and no better effectiveness with ciprofloxacin or azithromycin was observed.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; Versió publicada
Subject:	Cataract surgery ; Infectious postoperative endophtalmitis ; Topical antibiotics ; Cirugía de cataratas ; Endoftalmitis infecciosa post-operatoria ; Antibióticos tópicos
Published in:	Revista Española de Quimioterapia, Vol. 31 (november 2018) , p. 499-505, ISSN 1988-9518

PMID: 30421880

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