Prophylaxis of Acute Posttraumatic Bacterial Endophthalmitis
- 1 April 2007
- journal article
- research article
- Published by American Medical Association (AMA) in Archives of Ophthalmology (1950)
- Vol. 125 (4) , 460-465
- https://doi.org/10.1001/archopht.125.4.460
Abstract
Objective To evaluate the efficacy of intraocular gentamicin sulfate and clindamycin in the prevention of acute posttraumatic bacterial endophthalmitis following penetrating eye injuries. Method We conducted a multicenter, randomized, double-masked controlled trial of 346 eyes with penetrating eye injury. Following primary repair, eyes were randomized to intracameral or intravitreal injection of 40 μg of gentamicin sulfate and 45 μg of clindamycin (cases) vs balanced salt solution (controls). Main Outcome Measure Occurrence of endophthalmitis within 2 weeks. Results Endophthalmitis occurred in 8 (2.3%) of 167 eyes in the control group and only in 1 (0.3%) of 179 eyes in the case group (P = .04; odds ratio, 8.93 [95% confidence interval, 1.11-71.43]). In eyes with an intraocular foreign body, endophthalmitis developed in 7 of 25 control eyes and in none of 27 eyes receiving antibiotics. However, in eyes without an intraocular foreign body, endophthalmitis developed in 1 of 142 eyes and 1 of 152 eyes in the 2 groups, respectively (Pvalue for interaction = .04). Intravitreal injection was superior to intracameral injection in preventing endophthalmitis (Pvalue for interaction = .01). Vitreous culture results were positive in 6 (67%) of 9 eyes with endophthalmitis. Conclusion Intraocular gentamicin and clindamycin are effective in the prevention of acute posttraumatic bacterial endophthalmitis in eyes with retained intraocular foreign body. Application to Clinical Practice Prophylaxis of traumatic endophthalmitis. Trial Registration clinicaltrials.gov Identifier:"http://clinicaltrials.gov/ct/show/NCT00398658"Keywords
This publication has 1 reference indexed in Scilit:
- PROGNOSTIC FACTORS IN OCULAR INJURIES CAUSED BY INTRAOCULAR OR RETROBULBAR FOREIGN BODIESEvidence-Based Eye Care, 2000