Are Prophylactic Systemic Antibiotics Required in Patients with Cataract Surgery at Local Anesthesia?

Area of Science:

• Ophthalmology
• Infectious Diseases
• Pharmacology

Background:

• Global recommendations advocate for reduced antimicrobial drug use to combat antimicrobial resistance.
• Cataract surgery, a common procedure, has historically involved prophylactic systemic antibiotics.

Purpose of the Study:

• To evaluate the incidence of surgical site infections (SSIs) during a phased reduction of prophylactic systemic antibiotics for cataract surgery.
• To determine the safety and efficacy of minimizing or eliminating systemic antibiotic prophylaxis in cataract surgery.

Main Methods:

• A retrospective review of 2,189 cataract surgeries performed between 2016 and 2022.
• The study period was divided into five stages with progressively reduced systemic antibiotic regimens, culminating in no systemic antibiotics in Stage 5.
• All patients received topical moxifloxacin and ocular surface irrigation with povidone-iodine.

Main Results:

• No surgical site infections were recorded across all five stages of the study.
• The reduction and eventual cessation of prophylactic systemic antibiotics did not lead to an increase in SSIs.
• Local precautionary measures, including topical antibiotics and povidone-iodine irrigation, were consistently applied.

Conclusions:

• Prophylactic systemic antibiotics can be safely reduced and potentially eliminated in cataract surgery.
• Strict adherence to local antiseptic and prophylactic measures is crucial for preventing SSIs.
• This approach supports global efforts to reduce antimicrobial resistance without compromising patient safety in cataract surgery.