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Topical antibiotics and intravitreal injections
Alex P Hunyor1,2, Rohan Merani3,4, Archie Darbar5
1University of Sydney, Sydney, New South Wales, Australia.
Acta Ophthalmologica
|April 26, 2017
Summary
Topical antibiotics are ineffective and potentially harmful for preventing endophthalmitis after intravitreal injections. Focus should shift to aseptic techniques, not antibiotics, for better patient outcomes and reduced resistance.
Area of Science:
- Ophthalmology
- Infectious Disease Prevention
- Pharmacology
Background:
- Topical antibiotic use before/after intravitreal injections is common practice globally.
- Evidence suggests these antibiotics are ineffective for preventing endophthalmitis.
- Concerns exist regarding increased antibiotic resistance and costs associated with their use.
Purpose of the Study:
- To review the evidence on topical antibiotic prophylaxis for endophthalmitis post-intravitreal injection.
- To highlight the ineffectiveness and potential harms of current practices.
- To advocate for a shift towards proven preventive measures.
Main Methods:
- Literature review of studies investigating antibiotic prophylaxis for intravitreal injections.
- Analysis of evidence regarding efficacy, resistance, and cost-effectiveness.
- Discussion of current clinical practices and guidelines.
Main Results:
- Topical antibiotics show no efficacy in preventing endophthalmitis following intravitreal injections.
- Their use contributes to the development of resistant microbial organisms.
- Antisepsis and aseptic techniques are the primary proven methods for endophthalmitis prevention.
Conclusions:
- Widespread education of ophthalmologists is needed to discontinue inappropriate topical antibiotic use.
- Revisions to drug labels and professional guidelines may be necessary.
- Emphasis must be placed on rigorous antisepsis and aseptic technique for endophthalmitis prevention.
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