Antibiotic prophylaxis: different practice patterns within and outside the United States

Figures & data

Figure 1 External photograph, left eye, demonstrating acute-onset postoperative endophthalmitis following cataract surgery.

Notes: Vitreous cultures isolated Staphylococcus epidermidis. Following treatment, visual acuity improved to 20/25.

Table 1 Selected reports of intracameral antibiotics in cataract surgery

Series	n	Nation	Antibiotics	Rate without intracameral antibiotics (%)	Rate with intracameral antibiotics (%)	P-value
ESCRS^Citation10,*	16,603	Multiple	Cefuroxime	0.18–0.23	0.025–0.050	0.005
Yu-Wai-Man et al^Citation12	36,743	UK	Cefuroxime	0.14	0.046	0.0068
Garat et al^Citation13	18,579	Spain	Cefazolin	0.39	0.032	<0.0000001
Barreau et al^Citation16	5,115	France	Cefuroxime	1.24	0.044	<0.0001
Romero-Aroca et al^Citation14	25,001	Spain	Cefazolin	0.63	0.05	<0.001
Tan et al^Citation17	50,177	Singapore	Cefazolin	0.064	0.01	<0.001
Friling et al^Citation20	464,996	Sweden	Cefuroxime	0.39	0.027	<0.001
Matsuura et al^Citation21	34,752	Japan	Moxifloxacin	0.051	0.015	0.037
Shorstein et al^Citation18	16,264	USA	Multiple	0.31	0.014–0.14	NR
Rodriguez-Caravaca et al^Citation15	19,463	Spain	Cefuroxime	0.59	0.039	<0.05
Beselga et al^Citation22	15,689	Portugal	Cefuroxime	0.26	0	<0.05
Rudnisky et al^Citation25,**	75,318	Canada	Multiple	0.03	0.03	0.90
Herrinton et al^Citation19	315,246	USA	Multiple	0.07–0.14	0.044	NR
Katz et al^Citation24	56,094	Israel	Cefuroxime	0.083	0.034	0.03
Rahman and Murphy^Citation23	16,975	Ireland	Cefuroxime	0.49	0.06	<0.0001
Sharma et al^Citation26,**	15,122	India	Cefuroxime	0.16	0.11	0.38

Notes:

* Randomized clinical trial.

** Series reporting no significant difference in endophthalmitis rates.

Abbreviations: ESCRS, European Society of Cataract and Refractive Surgeons; NR, not reported.

Table 2 Selected reports of topical antibiotics with intravitreal injection

Series	n	Nation	Rate without topical antibiotics (%)	Rate with topical antibiotics (%)	P-value
Bhatt et al^Citation39	4,767	USA	0.20	0.22	0.75
Bhavsar et al^Citation40	8,027	USA	0.03	0.13	0.25
Cheung et al^Citation44	15,895	Canada	0.038	0.061–0.084	NR
Falavarjani et al^Citation45	5,901	Iran	0	0.10	0.18
Park et al^Citation47	17,332	Korea	0.035	0	0.81
Ramel et al^Citation49,*	11,450	France	0.2	0.03	0.024
Storey et al^Citation41	117,171	USA	0.032	0.049	NR
Falavarjani et al^Citation46	8,037	Iran	0	0.01	0.30
Gregori et al^Citation43	121,285	USA	0.02	0.013	0.38
Meredith et al^Citation42	18,509	USA	0.15	0.04–0.08	0.20

Note:

* Series reporting significant difference in endophthalmitis rates.

Abbreviation: NR, not reported.

ESCRS Endophthalmitis Study GroupProphylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factorsJ Cataract Refract Surg200733697898817531690

 PubMed Web of Science ®Google Scholar

Yu-Wai-ManPMorganSJHildrethAJSteelDHAllenDEfficacy of intracameral and subconjunctival cefuroxime in preventing endophthalmitis after cataract surgeryJ Cataract Refract Surg200834344745118299070

 PubMed Web of Science ®Google Scholar

GaratMMoserCLMartin-BaraneraMAlonso-TarresCAlvarez-RubioLProphylactic intracameral cefazolin after cataract surgery: endophthalmitis risk reduction and safety results in a 6-year studyJ Cataract Refract Surg200935463764219304083

 PubMed Web of Science ®Google Scholar

BarreauGMounierMMarinBAdenisJPRobertPYIntracameral cefuroxime injection at the end of cataract surgery to reduce the incidence of endophthalmitis: French studyJ Cataract Refract Surg20123881370137522814043

 PubMed Web of Science ®Google Scholar

Romero-ArocaPMendez-MarinISalvat-SerraMFernández-BallartJAlmena-GarciaMReyes-TorresJResults at seven years after the use of intracamerular cefazolin as an endophthalmitis prophylaxis in cataract surgeryBMC Ophthalmol201212210.1186/1471-2415-12-222272570

 PubMed Web of Science ®Google Scholar

TanCSWongHKYangFPEpidemiology of postoperative endophthalmitis in an Asian population: 11-year incidence and effect of intracameral antibiotic agentsJ Cataract Refract Surg201238342543022245169

 PubMed Web of Science ®Google Scholar

FrilingELundstromMSteneviUMontanPSix-year incidence of endophthalmitis after cataract surgery: Swedish national studyJ Cataract Refract Surg2013391152123245359

 PubMed Web of Science ®Google Scholar

MatsuuraKMiyoshiTSutoCAkuraJInoueYEfficacy and safety of prophylactic intracameral moxifloxacin injection in JapanJ Cataract Refract Surg201339111702170624054967

 PubMed Web of Science ®Google Scholar

ShorsteinNHWinthropKLHerrintonLJDecreased postoperative endophthalmitis rate after institution of intracameral antibiotics in a Northern California eye departmentJ Cataract Refract Surg201339181423036356

 PubMed Web of Science ®Google Scholar

Rodriguez-CaravacaGGarcia-SaenzMCVillar-Del CampoMCAndres-AlbaYArias-PuenteAIncidence of endophthalmitis and impact of prophylaxis with cefuroxime on cataract surgeryJ Cataract Refract Surg20133991399140323820306

 PubMed Web of Science ®Google Scholar

BeselgaDCamposACastroMPostcataract surgery endophthalmitis after introduction of the ESCRS protocol: a 5-year studyEur J Ophthalmol201424451651924366770

 PubMed Web of Science ®Google Scholar

RudniskyCJWanDWeisEAntibiotic choice for the prophylaxis of post-cataract extraction endophthalmitisOphthalmology2014121483584124326107

 PubMed Web of Science ®Google Scholar

HerrintonLJShorsteinNHPaschalJFComparative effectiveness of antibiotic prophylaxis in cataract surgeryOphthalmology Epub2015109

 Google Scholar

KatzGBlumSLeevaOIntracameral cefuroxime and the incidence of post-cataract endophthalmitis: an Israeli experienceGraefes Arch Clin Exp Ophthalmol2015253101729173325904294

 PubMed Web of Science ®Google Scholar

RahmanNMurphyCCImpact of intracameral cefuroxime on the incidence of postoperative endophthalmitis following cataract surgery in IrelandIr J Med Sci2015184239539824846749

 PubMed Web of Science ®Google Scholar

SharmaSSahuSKDhillonVDasSRathSReevaluating intracameral cefuroxime as a prophylaxis against endophthalmitis after cataract surgery in IndiaJ Cataract Refract Surg201541239339925535109

 PubMed Web of Science ®Google Scholar

BhattSSStepienKEJoshiKProphylactic antibiotic use after intravitreal injection: effect on endophthalmitis rateRetina2011312032203621659941

 PubMed Web of Science ®Google Scholar

BhavsarARStockdaleCRFerrisFLUpdate on risk of endophthalmitis after intravitreal drug injections and potential impact of elimination of topical antibioticsArch Ophthalmol2012130680981022801859

 PubMed Web of Science ®Google Scholar

CheungCSWongAWLuiAKertesPJDevenyiRGLamWCIncidence of endophthalmitis and use of antibiotic prophylaxis after intravitreal injectionsOphthalmology201211981609161422480743

 PubMed Web of Science ®Google Scholar

FalavarjaniKGModarresMHashemiMIncidence of acute endophthalmitis after intravitreal bevacizumab injection in a single clinical centerRetina201333597197423400076

 PubMed Web of Science ®Google Scholar

ParkYKimKSParkYHAcute endophthalmitis after intravitreal injection and preventive effect of preoperative topical antibioticsJ Ocul Pharmacol Ther2013291090090524067061

 PubMed Web of Science ®Google Scholar

RamelJCBronAMIsaicoRIncidence de l’endophtalmie après injection intravitréenne: peuton se passer de l’antibioprophylaxie? [Incidence of endophthalmitis after intravitreal injection: is antibioprophylaxis mandatory?]J Fr Ophthalmol2014374273279 French

 Web of Science ®Google Scholar

StoreyPDollinMPitcherJThe role of topical antibiotic prophylaxis to prevent endophthalmitis after intravitreal injectionOphthalmology2014121128328924144453

 PubMed Web of Science ®Google Scholar

FalavarjaniKGAghamirsalimMModarresMEndophthalmitis after resident-performed intravitreal bevacizumab injectionCan J Ophthalmol2015501333625677280

 PubMed Web of Science ®Google Scholar

GregoriNZFlynnHWJrSchwartzSGCurrent infectious endophthalmitis rates after intravitreal injections of anti-vascular endothelial growth factor agents and outcomes of treatmentOphthalmic Surg Lasers Imaging Retina201546664364826114845

 PubMed Web of Science ®Google Scholar

MeredithTAMcCannelCABarrCPostinjection endophthalmitis in the comparison of age-related macular degeneration treatments trials (CATT)Ophthalmology2015122481782125600198

 PubMed Web of Science ®Google Scholar