Endophthalmitis after cataract surgery and effect of different intracameral antibiotic regimes in Sweden 2011-2017 : National registry study
(2024) In Journal of Cataract and Refractive Surgery 50(8). p.828-835- Abstract
Purpose:To study the incidence, predictive factors, etiology, and visual consequences of postoperative endophthalmitis (PE) in relation to 3 intracameral (IC) antibiotic regimes.Setting:Swedish National Cataract Register entries from 2011 through 2017.Design:Observational retrospective study.Methods:PE incidence, influencing factors, bacteriology, and visual outcome were analyzed regarding the 3 major prophylactic IC protocols.Results:The overall incidence of PE was 0.023% or 177 cases in 764 513 cataract procedures. Analyzed per IC regime, the rates of PE were 0.024% (126 cases in 514 916 surgeries) for cefuroxime, 0.020% (25 cases in 122 340 surgeries) for moxifloxacin, and 0.017% (20 cases in 121 045 surgeries) for combined... (More)
Purpose:To study the incidence, predictive factors, etiology, and visual consequences of postoperative endophthalmitis (PE) in relation to 3 intracameral (IC) antibiotic regimes.Setting:Swedish National Cataract Register entries from 2011 through 2017.Design:Observational retrospective study.Methods:PE incidence, influencing factors, bacteriology, and visual outcome were analyzed regarding the 3 major prophylactic IC protocols.Results:The overall incidence of PE was 0.023% or 177 cases in 764 513 cataract procedures. Analyzed per IC regime, the rates of PE were 0.024% (126 cases in 514 916 surgeries) for cefuroxime, 0.020% (25 cases in 122 340 surgeries) for moxifloxacin, and 0.017% (20 cases in 121 045 surgeries) for combined cefuroxime-Ampicillin. Incidences were not statistically significantly different from one another. Gram-positive bacteria caused 89.0% of culture positive cases. Enterococci as pathogens were significantly more frequent with IC cefuroxime than with moxifloxacin, P =.006, or cefuroxime-Ampicillin, P <.001, while streptococci other than enterococci were more common with moxifloxacin than with cefuroxime, P <.001. Bacterial susceptibility to the given antibiotics was demonstrated in 21.3% of PE cases treated with cefuroxime, which was statistically significantly lower than proportions found with cefuroxime-Ampicillin, 60.0%, P =.015, or with moxifloxacin, 88.2%, P <.001. Visual outcome worse than 20/200 was similar in the groups ranging from 42.0% to 53.7%.Conclusions:No statistically significant differences in PE incidence or visual outcome results between treatment groups were demonstrated. However, differences in etiology and bacterial sensitivity were found between the prophylactic IC treatments.
(Less)
- author
- Friling, Emma ; Bro, Tomas LU ; Lundström, Mats LU and Montan, Per
- organization
- publishing date
- 2024-08
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Cataract and Refractive Surgery
- volume
- 50
- issue
- 8
- pages
- 8 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:38661497
- scopus:85200366665
- ISSN
- 0886-3350
- DOI
- 10.1097/j.jcrs.0000000000001464
- language
- English
- LU publication?
- yes
- id
- 0fe04795-793e-4386-8890-b19e65675782
- date added to LUP
- 2024-09-10 15:13:25
- date last changed
- 2024-09-10 15:14:46
@article{0fe04795-793e-4386-8890-b19e65675782,
abstract = {{<p>Purpose:To study the incidence, predictive factors, etiology, and visual consequences of postoperative endophthalmitis (PE) in relation to 3 intracameral (IC) antibiotic regimes.Setting:Swedish National Cataract Register entries from 2011 through 2017.Design:Observational retrospective study.Methods:PE incidence, influencing factors, bacteriology, and visual outcome were analyzed regarding the 3 major prophylactic IC protocols.Results:The overall incidence of PE was 0.023% or 177 cases in 764 513 cataract procedures. Analyzed per IC regime, the rates of PE were 0.024% (126 cases in 514 916 surgeries) for cefuroxime, 0.020% (25 cases in 122 340 surgeries) for moxifloxacin, and 0.017% (20 cases in 121 045 surgeries) for combined cefuroxime-Ampicillin. Incidences were not statistically significantly different from one another. Gram-positive bacteria caused 89.0% of culture positive cases. Enterococci as pathogens were significantly more frequent with IC cefuroxime than with moxifloxacin, P =.006, or cefuroxime-Ampicillin, P <.001, while streptococci other than enterococci were more common with moxifloxacin than with cefuroxime, P <.001. Bacterial susceptibility to the given antibiotics was demonstrated in 21.3% of PE cases treated with cefuroxime, which was statistically significantly lower than proportions found with cefuroxime-Ampicillin, 60.0%, P =.015, or with moxifloxacin, 88.2%, P <.001. Visual outcome worse than 20/200 was similar in the groups ranging from 42.0% to 53.7%.Conclusions:No statistically significant differences in PE incidence or visual outcome results between treatment groups were demonstrated. However, differences in etiology and bacterial sensitivity were found between the prophylactic IC treatments.</p>}},
author = {{Friling, Emma and Bro, Tomas and Lundström, Mats and Montan, Per}},
issn = {{0886-3350}},
language = {{eng}},
number = {{8}},
pages = {{828--835}},
publisher = {{Elsevier}},
series = {{Journal of Cataract and Refractive Surgery}},
title = {{Endophthalmitis after cataract surgery and effect of different intracameral antibiotic regimes in Sweden 2011-2017 : National registry study}},
url = {{http://dx.doi.org/10.1097/j.jcrs.0000000000001464}},
doi = {{10.1097/j.jcrs.0000000000001464}},
volume = {{50}},
year = {{2024}},
}