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Updated: Jan 21, 2026

Intravitreal Injections in the Ovine Eye
Published on: July 5, 2022
[Antibiotic resistance in patients after serial intravitreal injections]
G V Voronin1, M V Budzinskaya1, M G Strakhovskaya2
1Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021.
Abstract:
Despite the lack of convincing data on the effectiveness of antibiotic therapy in the prevention of Post-Injection Endophthalmitis (PIE), the use of topical antibiotics for intravitreal injections is still a common practice. Frequent, monthly use of antibiotics results in changes of the composition of conjunctival flora and spontaneous mutations of bacteria, and leads to selective survival of resistant and virulent strains that can cause serious damage inside the eye.
Insights
Topical antibiotic use before eye injections lacks proven benefit for preventing post-injection endophthalmitis (PIE). Routine antibiotic use promotes resistant bacterial strains, potentially increasing eye infection risk.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Topical antibiotic prophylaxis is commonly used before intravitreal injections.
- Evidence supporting its efficacy in preventing post-injection endophthalmitis (PIE) is limited.
- This practice may contribute to the development of antibiotic resistance.
Purpose of the Study:
- To evaluate the necessity and potential risks of routine topical antibiotic use.
- To analyze the impact of frequent antibiotic administration on ocular surface microbiota.
- To highlight the emergence of resistant bacterial strains due to selective pressure.
Main Methods:
- Review of current clinical practices and available scientific literature.
- Analysis of the effects of antibiotic exposure on bacterial flora composition.
- Assessment of the link between antibiotic resistance and ocular infection severity.
Main Results:
- Convincing data on the effectiveness of topical antibiotics in PIE prevention is lacking.
- Frequent antibiotic use alters conjunctival flora composition.
- Selective survival of resistant and virulent bacterial strains is observed.
Conclusions:
- The routine use of topical antibiotics before intravitreal injections may be unwarranted.
- This practice can lead to the proliferation of resistant pathogens.
- Potential risks include increased virulence and severe intraocular damage.
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