Endophthalmitis Prophylaxis Failures in Patients Injected With Intracameral Antibiotic During Cataract Surgery.
Endophthalmitis Prophylaxis Failures in Patients Injected With Intracameral Antibiotic During Cataract Surgery.
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DOI：
10.1016/j.ajo.2021.02.007
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发表时间：
2021-07
影响因子：
4.2
通讯作者：
Herrinton L
中科院分区：
文献类型：
--
作者：
Shorstein NH;Liu L;Carolan JA;Herrinton L
为了评估头孢呋辛和莫西沙星与超声乳化白内障手术后眼内炎的相关性，回顾临床队列研究，我们研究了2014-2019年在北加州凯撒永久性接受非复杂超声乳化白内障手术的患者。获得了超声乳化术后90天内急性眼内炎的数据，包括培养和抗菌结果；房内和外用抗生素的使用和剂量。在一项术后分析中，我们还检查了术前前房深度(ACD)和术后前房体积(ACV)。在216,141例手术中，注射莫西沙星的眼内炎发生率为0.020%，头孢呋辛为0.013%(相对危险度为1.6 2，95%可信区间为0.82~3.2 0，P=0.16)。眼内炎34例(0.016%)，注射头孢呋辛1 mg 13只眼，注射0.1%莫西沙星21只眼。在12例(35%)病例中发现了具有抗菌图谱的微生物。其中，从注射头孢呋辛中找到的细菌在所有病例中都对头孢呋辛耐药(4/4)，其中肠球菌占一半。注射0.1%莫西沙星的7只眼中，6只眼对0.1毫升的莫西沙星敏感，1只眼对1只眼的莫西沙星敏感。在莫西沙星注射眼中，链球菌是最常见的致病菌(6/9)。注射莫西沙星的眼术前ACD和术后计算的ACV均较高。培养阳性的眼内炎患者一般与头孢呋辛眼的细菌耐药有关，但与莫西沙星眼的敏感细菌有关。对于ACV较大的眼睛，莫西沙星的剂量可能不足。在对216,141例白内障手术的回顾分析中，0.1%莫西沙星组术后眼内炎的发生率(0.020%)略高于头孢呋辛组(0.013%)，但差异无统计学意义。从莫西沙星组回收的微生物通常对药物敏感，而来自头孢呋辛眼部的微生物对药物敏感。莫西沙星的剂量可能不足。
To estimate the association of cefuroxime and moxifloxacin in relation to the occurrence of endophthalmitis following phacoemulsification cataract surgery Retrospective clinical cohort study We studied patients with noncomplex phacoemulsification cataract surgery in Kaiser Permanente Northern California during 2014–2019. Data was obtained for acute, postoperative endophthalmitis within 90 days of phacoemulsification, including culture and antibiogram results; intracameral and topical antibiotic agent and dose. In a post hoc analysis, we also examined preoperative anterior chamber depth (ACD) and postoperative anterior chamber volume (ACV). Of 216,141 surgeries, endophthalmitis occurred in 0.020% of moxifloxacin injected eyes and 0.013% of cefuroxime eyes (relative risk 1.62 with 95% CI 0.82–3.20, P=0.16). Of the 34 (0.016%) cases of endophthalmitis, cefuroxime 1 mg was injected into 13 eyes and moxifloxacin 0.1% into 21 eyes. Organisms with antibiograms were identified in 12 (35%) cases. Of these, bacteria recovered from cefuroxime injected eyes were resistant to cefuroxime in all cases (4/4) with Enterococcus comprising half of these. In eyes injected with moxifloxacin 0.1%, 6 out of 7 organisms were sensitive to moxifloxacin injected with 0.1 mL and in 1 eye injected with 1 mL. Streptococcus was the most common organism recovered (6/9) in moxifloxacin injected eyes. Preoperative ACD and postoperative calculated ACV were higher in eyes injected with moxifloxacin. Endophthalmitis cases with positive cultures were generally related to organism resistance in cefuroxime eyes but to sensitive organisms in moxifloxacin eyes. Moxifloxacin doses may have been insufficient in eyes with larger ACV. In a retrospective analysis of 216,141 cataract surgeries, the group of eyes injected with 0.1 mL of moxifloxacin 0.1% had a slightly higher frequency of postoperative endophthalmitis (0.020%) than cefuroxime eyes (0.013%), though the difference was not statistically significant. Recovered organisms from the moxifloxacin group were generally sensitive to the drug while organisms from cefuroxime eyes were resistant. The moxifloxacin dose may have been insufficient.
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影响因子：
2.8
作者：
Haruki, Tomoko;Miyazaki, Dai;Yamagami, Satoru
通讯作者：
Yamagami, Satoru
影响因子：
2.8
作者：
Shorstein, Neal H.;Gardner, Susanne
通讯作者：
Gardner, Susanne
影响因子：
2.8
作者：
Montan, PG;Wejde, G;Zetterström, C
通讯作者：
Zetterström, C
DOI：
10.2147/opth.s68370
发表时间：
2014
期刊：
Clinical ophthalmology (Auckland, N.Z.)
影响因子：
--
作者：
Kanellopoulos AJ;Asimellis G
通讯作者：
Asimellis G
影响因子：
13.7
作者：
Creuzot-Garcher, Catherine;Benzenine, Eric;Quantin, Catherine
通讯作者：
Quantin, Catherine