Fusidic acid prophylaxis before cataract surgery: patient self-administration

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Pseudophakic endophthalmitis is a severe post-operative complication.
• Staphylococcus species are the most common causative organisms.
• Pre-operative bacterial load on ocular surfaces is a risk factor.

Purpose of the Study:

• To evaluate the efficacy of patient-administered 1% fusidic acid viscous eye drops.
• To reduce bacterial colonization of lids and conjunctivae prior to cataract surgery.
• To assess the impact on common pathogens causing endophthalmitis.

Main Methods:

• A placebo-controlled, randomized, double-blind clinical trial.
• 79 patients undergoing cataract surgery were enrolled.
• Treatment involved self-administration of fusidic acid or placebo drops four times daily for seven days pre-surgery.

Main Results:

• Fusidic acid significantly reduced Staphylococcus spp. on lids (P << 0.001) and conjunctivae (P = 0.02).
• Lid margins were rendered clinically clean in a highly significant number of cases (P < 0.001).
• A significant reduction in non-Staphylococcus bacteria was also observed (P << 0.001).

Conclusions:

• Patient self-administration of 1% fusidic acid eye drops is highly effective.
• Pre-operative treatment significantly reduces ocular surface bacterial load.
• This approach contributes to achieving sterile eyes at operation, potentially reducing endophthalmitis risk.