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Emerging Antibiotic Resistance Patterns Affect Visual Outcome Treating Acute Endophthalmitis

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 month...

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Autores principales: Wu, Xia-Ni, Chen, Yi-Hsing, Sharief, Lazha, Al-Janabi, Ahmed, Al Qassimi, Nura, Lightman, Sue, Tomkins-Netzer, Oren
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9311540/
https://www.ncbi.nlm.nih.gov/pubmed/35884097
http://dx.doi.org/10.3390/antibiotics11070843
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author Wu, Xia-Ni
Chen, Yi-Hsing
Sharief, Lazha
Al-Janabi, Ahmed
Al Qassimi, Nura
Lightman, Sue
Tomkins-Netzer, Oren
author_facet Wu, Xia-Ni
Chen, Yi-Hsing
Sharief, Lazha
Al-Janabi, Ahmed
Al Qassimi, Nura
Lightman, Sue
Tomkins-Netzer, Oren
author_sort Wu, Xia-Ni
collection PubMed
description 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.
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spelling pubmed-93115402022-07-26 Emerging Antibiotic Resistance Patterns Affect Visual Outcome Treating Acute Endophthalmitis Wu, Xia-Ni Chen, Yi-Hsing Sharief, Lazha Al-Janabi, Ahmed Al Qassimi, Nura Lightman, Sue Tomkins-Netzer, Oren Antibiotics (Basel) Article 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. MDPI 2022-06-23 /pmc/articles/PMC9311540/ /pubmed/35884097 http://dx.doi.org/10.3390/antibiotics11070843 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wu, Xia-Ni
Chen, Yi-Hsing
Sharief, Lazha
Al-Janabi, Ahmed
Al Qassimi, Nura
Lightman, Sue
Tomkins-Netzer, Oren
Emerging Antibiotic Resistance Patterns Affect Visual Outcome Treating Acute Endophthalmitis
title Emerging Antibiotic Resistance Patterns Affect Visual Outcome Treating Acute Endophthalmitis
title_full Emerging Antibiotic Resistance Patterns Affect Visual Outcome Treating Acute Endophthalmitis
title_fullStr Emerging Antibiotic Resistance Patterns Affect Visual Outcome Treating Acute Endophthalmitis
title_full_unstemmed Emerging Antibiotic Resistance Patterns Affect Visual Outcome Treating Acute Endophthalmitis
title_short Emerging Antibiotic Resistance Patterns Affect Visual Outcome Treating Acute Endophthalmitis
title_sort emerging antibiotic resistance patterns affect visual outcome treating acute endophthalmitis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9311540/
https://www.ncbi.nlm.nih.gov/pubmed/35884097
http://dx.doi.org/10.3390/antibiotics11070843
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