[Management of endophthalmitis in French university hospitals: A national survey]

Endophthalmitis is a rare but serious ophthalmologic emergency that can lead to permanent vision loss. Due to limited literature on the subject, many aspects of its management remain controversial. This study aims to provide an overview of current management practices in French university hospitals (CHU).

A descriptive, observational, cross-sectional survey was conducted among hospital-based ophthalmologists working in CHUs using an online questionnaire. It covered diagnostic and therapeutic modalities (medical and surgical), as well as the presence of institutional protocols.

Twenty-eight centers participated. Systemic antibiotic therapy was used in 64.3% of cases; intravenous induction followed by oral continuation was employed in 72.2% of reported cases. Levofloxacin is the most frequently prescribed antibiotic (94.4% of centers reporting use of systemic antibiotic therapy). Intravitreal injections (mainly vancomycin/ceftazidime) were systematically performed, although the number of injections varied between centers. Surgery during the "acute" phase was performed in 75% of CHUs, although the indication criteria were heterogeneous.

This study highlights significant variability in the management of endophthalmitis in French university hospitals. It underscores the absence of recent national guidelines and the need for multicenter studies to evaluate therapeutic strategies, particularly the role of systemic antibiotic therapy and surgical indications for vitrectomy.