Prophylactic antibiotic use after intravitreal injection: effect on endophthalmitis rate

Endophthalmitis after intravitreal injection is a serious complication. There are limited data to support the use of postinjection antibiotics to prevent endophthalmitis. Current endophthalmitis rates after intravitreal injection in the literature are based on studies where patients routinely received postinjection antibiotics. This study retrospectively compares the rate of endophthalmitis in a cohort of patients receiving postinjection antibiotics with that in a group that does not.

A retrospective chart review was performed comparing a 12-month period where patients received postinjection topical antibiotics for several days after intravitreal injection with the next 12-month period where no postinjection topical antibiotics were used. Cases of suspected endophthalmitis after intravitreal injection during this period were identified and reviewed.

The rate of clinically suspected endophthalmitis in the cohort of patients receiving postinjection antibiotics after intravitreal injection and that in the cohort that did not was 0.22% and 0.20%, respectively. One culture-positive case was found overall. The difference between the 2 groups is not statistically significant (P = 0.75).

The rate of endophthalmitis after intravitreal injections administered in a clinical practice setting when aseptic technique is used is similar with or without the use of postinjection antibiotics.