Antibiotic prophylaxis of acute postoperative endophthalmitis
DOI: 10.32364/2311-7729-2021-21-4-220-226
V.P. Nikolaenko1,2, D.F. Belov1
1City Multidisciplinary Hospital No. 2, St. Petersburg, Russian Federation
2St. Petersburg State University, St. Petersburg, Russian Federation
This paper reviews current aspects of antibacterial prophylaxis of acute endophthalmitis, a dangerous complication of cataract surgery. The lack of a common standard for preventing phaco infectious complications, a growing number of resistant bacterial strains, and legal aspects of the lack of some antibiotic formulations and routes of their administration with established efficacy in Russia account for the importance of this issue.
The authors provide a list of primary causative agents of endophthalmitis and specify their antimicrobial susceptibility, highlight the importance of using antiseptics to prevent endophthalmitis, and describe in detail routes of administration of antibiotics, including conventional ones (subconjunctival injections, topical use) and whose actively promoted (intracameral, transzonular).
In conclusion, the authors suggested a rational antimicrobial preventive algorithm for endophthalmitis after phaco based on the analysis of recent Russian and foreign published data and adapted to the Russian health care system.
Keywords: phacoemulsification, endophthalmitis, antiseptic, antibiotic, prophylaxis, antibacterial resistance, fluoroquinolones, aminoglycosides, povidone-iodine, intracameral administration.
For citation: Nikolaenko V.P., Belov D.F. Antibiotic prophylaxis of acute postoperative endophthalmitis. Russian Journal of Clinical Ophthalmology. 2021;21(4):220–226 (in Russ.). DOI: 10.32364/2311-7729-2021-21-4-220-226.
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3. Sharma B., Abell R.G., Arora T. et al. Techniques of anterior capsulotomy in cataract surgery. Indian J Ophthalmol. 2019;67(4):450–460. DOI: 10.4103/ijo.IJO_1728_18.
4. Durand M.L. Endophthalmitis. Clin Microbiol Infect. 2013;19(3):227–234. DOI: 10.1111/1469-0691.12118.
5. Поляк М.С., Околов И.Н., Пирогов Ю.И. Антибиотики в офтальмологии. СПб.: Нестор-История; 2015:352. [Poliak M.S., Okolov I.N., Pirogov Yu.I Antibiotics in ophthalmology. SPb.: Nestor-Istoria; 2015:352 (in Russ.)].
6. Tervo T., Ljungberg P., Kautiainen T. et al. Prospective evaluation of external ocular microbial growth and aqueous humor contamination during cataract surgery. J Cataract Refract Surg. 1999;25(1):65–71. DOI: 10.1016/s0886-3350(99)80013-3.
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8. Pijl B.J., Theelen T., Tilanus M.A. et al. Acute endophthalmitis after cataract surgery: 250 consecutive cases treated at a tertiary referral center in the Netherlands. Am J Ophthalmol. 2010;149(3):482–487. DOI: 10.1016/j.ajo.2009.09.021.
9. Пирогов Ю.И., Шустрова Т.А., Обловацкая Е.С., Хромова Е.С. Влияние периоперационной антибактериальной профилактики с помощью глазных капель на основе фторхинолонов на микрофлору конъюнктивы у пациентов до и после факоэмульсификации. Офтальмология. 2020;17(1):111–116. [Pirogov Yu.I., Shustrova T.A., Oblovatskayа E.S., Khrоmova Е.S. Effect of perioperative antibacterial prophylaxis using eye drops with fluoroquinolones on conjunctival microflora in patients before and after phacoemulsification. Ophthalmology in Russia. 2020;17(1):111–116 (in Russ.)]. DOI: 10.18008/1816-5095-2020-1-111-116.
10. Sheng Y., Sun W., Gu Y. et al. Endophthalmitis after cataract surgery in China, 1995–2009. J Cataract Refract Surg. 2011;37(9):1715–1722. DOI: 10.1016/j.jcrs.2011.06.019.
11. Pershing S., Lum F., Hsu S. et al. Endophthalmitis after cataract surgery in the United States: A report from the intelligent research in Sight Registry, 2013–2017. Ophthalmology. 2020;127(2):151–158. DOI: 10.1016/j.ophtha.2019.08.026.
12. Kim S.H., Yu M.H., Lee J.H. et al. Endophthalmitis after cataract surgery in Korea: A Nationwide study evaluating incidence and risk factors in a Korean population. Yonsei Med J. 2019;60(5):467–473. DOI: 10.3349/ymj.2019.60.5.467.
13. Nowak M.S., Grzybowski A., Michalska-Małecka K. et al. Incidence and characteristics of endophthalmitis after cataract surgery in Poland, during 2010–2015. Int J Environ Res Public Health. 2019;16(12):2188. DOI: 10.3390/ijerph16122188.
14. Barry P., Cordoves L., Gardner S. ESCRS guidelines for prevention and treatment of endophthalmitis following cataract surgery. Co Dublin: Temple House, Temple Road, Blackrock. 2013;1–22.
15. Trinavarat A., Atchaneeyasakul L.O., Nopmaneejumruslers C. et al. Reduction of endophthalmitis rate after cataract surgery with preoperative 5% povidone-iodine. Dermatology. 2006;212(1):35–40. DOI: 10.1159/000089197.
16. Sauerbrei A. Bactericidal and virucidal activity of ethanol and povidone-iodine. Microbiology open. 2020;9(9):1097. DOI: 10.1002/mbo3.1097.
17. Apt L., Isenberg S., Yoshimori R., Paez J.H. Chemical preparation of the eye in ophthalmic surgery. III. Effect of povidone-iodine on the conjunctiva. Arch Ophthalmol. 1984;102(5):728–729. DOI: 10.1001/archopht.1984.01040030584025.
18. Иошин И.Э., Толчинская А.И., Оздербаева А.А. Антисептики при интравитреальных инъекциях. Acta Biomedica Scientifica. 2016;1(6):55–59. [Ioshin I.E., Tolchinskaya A.I., Ozderbayeva A.A. Antiseptics at intravitreal injections. Acta Biomedica Scientifica. 2016;1(6):55–59 (in Russ.)]. DOI: 10.12737/23735.
19. Salehpour F., Aghazadeh J., Mirzaei F. et al. Propionibacterium acnes infection in disc material and different antibiotic susceptibility in patients with lumbar disc herniation. Int J Spine Surg. 2019;13(2):146–152. DOI: 10.14444/6019.
20. Matsuura K., Miyoshi T., Suto C. et al. Efficacy and safety of prophylactic intracameral moxifloxacin injection in Japan. J Cataract Refract Surg. 2013;39(11):1702–1706. DOI: 10.1016/j.jcrs.2013.05.036.
21. Shorstein N.H., Winthrop K.L., Herrinton L.J. Decreased postoperative endophthalmitis rate after institution of intracameral antibiotics in a Northern California eye department. J Cataract Refract Surg. 2013;39(1):8–14. DOI: 10.1016/j.jcrs.2012.07.031.
22. Haripriya A., Chang D.F., Namburar S. et al. Efficacy of intracameral moxifloxacin endophthalmitis prophylaxis at Aravind eye hospital. Ophthalmology. 2016;123(2):302–308. DOI: 10.1016/j.ophtha.2015.09.037.
23. Bowen R.C., Zhou A.X., Bondalapati S. et al. Comparative analysis of the safety and efficacy of intracameral cefuroxime, moxifloxacin and vancomycin at the end of cataract surgery: a meta-analysis. Br J Ophthalmol. 2018;102(9):1268–1276. DOI: 10.1136/bjophthalmol-2017-311051.
24. Huang J., Wang X., Chen X. et al. Perioperative antibiotics to prevent acute endophthalmitis after ophthalmic surgery: a systematic review and meta-analysis. PLoS One. 2016;11(11):0166141. DOI: 10.1371/journal.pone.0166141.
25. Kessel L., Flesner P., Andresen J. et al. Antibiotic prevention of postcataract endophthalmitis: a systematic review and meta-analysis. Acta Ophthalmol. 2015;93(4):303–317. DOI: 10.1111/aos.12684.
26. Yao K., Zhang Z., Yang Y.H., Wu X.D. Aqueous humor penetration of topically applied ofloxacin, ciprofloxacin and tobramycin. Zhonghua Yan Ke Za Zhi. 2003;39(12):736–739.
27. Luthardt K., Beck R., Hehl E.M. et al. [Corneal penetration of various aminoglycosides and quinolones]. Klin Monbl Augenheilkd. 1998;213(3):141–146. DOI: 10.1055/s-2008-1034964.
28. Herrinton L.J., Shorstein N.H., Paschal J.F. et al. Comparative effectiveness of antibiotic prophylaxis in cataract surgery. Ophthalmology. 2016;123(2):287–294. DOI: 10.1016/j.ophtha.2015.08.039.
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