Role of prophylactic intravitreal antibiotics in open globe injuries

Indian J Ophthalmol. 2003 Mar;51(1):39-44.

Abstract

Purpose: To determine the efficacy of prophylactic intravitreal antibiotics in reducing the incidence of endophthalmitis after trauma.

Methods: This was a prospective, randomised, case control study of 70 consecutive patients with open globe injury. The patients were prospectively randomised into group I (32 eyes) and group II (38 eyes). Group I patients were given prophylactic intravitreal injection of vancomycin 1 mg and ceftazidime 2.25 mg at the conclusion of primary repair. Group II patients were not given prophylactic intravitreal antibiotics. All the patients received intravenous ciprofloxacin.

Results: The incidence of endophthalmitis was higher in group II (7 of 38 eyes; 18.42%) compared to group I (2 of 32 eyes; 6.25%). Both the patients who developed endophthalmitis despite prophylactic intravitreal antibiotics in group I had an initially undetected intraocular foreign body (eyelash) in the vitreous cavity.

Conclusions: Prophylactic intravitreal broad spectrum antibiotic injection decreases the risk of post-traumatic endophthalmitis.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Antibiotic Prophylaxis / methods*
  • Ceftazidime / therapeutic use*
  • Child
  • Child, Preschool
  • Drug Therapy, Combination / therapeutic use*
  • Endophthalmitis / prevention & control*
  • Eye Injuries, Penetrating / complications
  • Eye Injuries, Penetrating / drug therapy*
  • Female
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Prospective Studies
  • Vancomycin / therapeutic use*
  • Vitrectomy / methods
  • Vitreous Body / drug effects

Substances

  • Vancomycin
  • Ceftazidime