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- Title
Emerging Antibiotic Resistance Patterns Affect Visual Outcome Treating Acute Endophthalmitis.
- Authors
Wu, Xia-Ni; Chen, Yi-Hsing; Sharief, Lazha; Al-Janabi, Ahmed; Al Qassimi, Nura; Lightman, Sue; Tomkins-Netzer, Oren
- Abstract
Background: Examining the effect of antibiotic resistance, use of intravitreal antibiotics and systemic corticosteroids on visual outcome of eyes with acute endophthalmitis. Methods: We included 226 eyes with acute endophthalmitis, treated using a standardized protocol. Visual outcome up to 12 months was assessed related to biopsy results, antibiotics resistance and treatment regimens. Results: Vitreous biopsies were more likely to be culture-positive (41.1%) than anterior chamber biopsies (21.6%, p < 0.0001). Antibiotic resistance for amikacin was found in 19 eyes (24.7%), vancomycin in 29 eyes (31.5%) and moxiflocacin in 14 eyes (16.1%). At presentation 91.53% of eyes had BCVA < 20/40, reducing by 1 month to 69.94% (p < 0.0001) and remaining stable at 12 months. There was no difference in visual outcome for those receiving early systemic corticosteroids. Endophthalmitis following cataract surgery (OR 1.66, 1.04–2.66 95% CI, p = 0.03) and receiving intravitreal vancomycin (OR 3.15, 1.18–8.42 95% CI, p = 0.02) were associated with a greater chance of final BCVA ≥ 20/40. Conclusion: Using vitreous taps with intravitreal antibiotics, despite an increase in resistance to both vancomycin and moxifloxacin, results in a final BCVA > 20/200 in half of eyes and ≥20/40 in a third. Early treatment with intravitreal antibiotics should not be delayed.
- Subjects
DRUG resistance in bacteria; ENDOPHTHALMITIS; TREATMENT effectiveness; VANCOMYCIN resistance; CATARACT surgery
- Publication
Antibiotics (2079-6382), 2022, Vol 11, Issue 7, p843
- ISSN
2079-6382
- Publication type
Article
- DOI
10.3390/antibiotics11070843