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Topical Antibiotic Prophylaxis and Intravitreal Injections: Impact on the Incidence of Acute Endophthalmitis—A Nationwide Study in France from 2009 to 2018
Background: The dramatic increase in intravitreal injections (IVTs) has been accompanied by a greater need for safer procedures. The ongoing debate about topical antibiotic prophylaxis after IVTs emphasizes the importance of large-scale studies. We aimed to study the role of topical antibiotic proph...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9611403/ https://www.ncbi.nlm.nih.gov/pubmed/36297568 http://dx.doi.org/10.3390/pharmaceutics14102133 |
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author | Baudin, Florian Benzenine, Eric Mariet, Anne-Sophie Ghezala, Inès Ben Bron, Alain M. Daien, Vincent Gabrielle, Pierre-Henry Quantin, Catherine Creuzot-Garcher, Catherine |
author_facet | Baudin, Florian Benzenine, Eric Mariet, Anne-Sophie Ghezala, Inès Ben Bron, Alain M. Daien, Vincent Gabrielle, Pierre-Henry Quantin, Catherine Creuzot-Garcher, Catherine |
author_sort | Baudin, Florian |
collection | PubMed |
description | Background: The dramatic increase in intravitreal injections (IVTs) has been accompanied by a greater need for safer procedures. The ongoing debate about topical antibiotic prophylaxis after IVTs emphasizes the importance of large-scale studies. We aimed to study the role of topical antibiotic prophylaxis in reducing the risk of acute endophthalmitis after IVTs. Methods: Population-based cohort study, in France, from 2009 to 2018, including all French patients receiving IVTs of corticosteroids or anti-VEGF agents. Results: A total of 5,291,420 IVTs were performed on 605,434 patients. The rate of topical antibiotic prophylaxis after IVTs progressively decreased during the study period, with a sharp drop in 2014 (from 84.6% in 2009 to 27.4% in 2018). Acute endophthalmitis occurred in 1274 cases (incidence rate = 0.0241%). Although antibiotic prophylaxis did not alter the risk of endophthalmitis (p = 0.06), univariate analysis showed an increased risk after fluoroquinolone and aminoglycoside prophylaxis. This increased risk was not found in multivariate analysis. However, we observed an increased risk related to the use of fixed combinations of fluoroquinolones and aminoglycosides with corticosteroids (IRR = 1.89; 95% CI = 1.57–2.27%, antibiotics combined with corticosteroids). Conclusion: These results are consistent with the literature. Endophthalmitis rates after IVTs did not decrease with topical antibiotic prophylaxis. The use of a combination of antibiotics and corticosteroids doubles the risk of endophthalmitis and should be avoided. Avoiding antibiotic prophylaxis would reduce the costs and the potential risks of antibiotic resistance. |
format | Online Article Text |
id | pubmed-9611403 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96114032022-10-28 Topical Antibiotic Prophylaxis and Intravitreal Injections: Impact on the Incidence of Acute Endophthalmitis—A Nationwide Study in France from 2009 to 2018 Baudin, Florian Benzenine, Eric Mariet, Anne-Sophie Ghezala, Inès Ben Bron, Alain M. Daien, Vincent Gabrielle, Pierre-Henry Quantin, Catherine Creuzot-Garcher, Catherine Pharmaceutics Article Background: The dramatic increase in intravitreal injections (IVTs) has been accompanied by a greater need for safer procedures. The ongoing debate about topical antibiotic prophylaxis after IVTs emphasizes the importance of large-scale studies. We aimed to study the role of topical antibiotic prophylaxis in reducing the risk of acute endophthalmitis after IVTs. Methods: Population-based cohort study, in France, from 2009 to 2018, including all French patients receiving IVTs of corticosteroids or anti-VEGF agents. Results: A total of 5,291,420 IVTs were performed on 605,434 patients. The rate of topical antibiotic prophylaxis after IVTs progressively decreased during the study period, with a sharp drop in 2014 (from 84.6% in 2009 to 27.4% in 2018). Acute endophthalmitis occurred in 1274 cases (incidence rate = 0.0241%). Although antibiotic prophylaxis did not alter the risk of endophthalmitis (p = 0.06), univariate analysis showed an increased risk after fluoroquinolone and aminoglycoside prophylaxis. This increased risk was not found in multivariate analysis. However, we observed an increased risk related to the use of fixed combinations of fluoroquinolones and aminoglycosides with corticosteroids (IRR = 1.89; 95% CI = 1.57–2.27%, antibiotics combined with corticosteroids). Conclusion: These results are consistent with the literature. Endophthalmitis rates after IVTs did not decrease with topical antibiotic prophylaxis. The use of a combination of antibiotics and corticosteroids doubles the risk of endophthalmitis and should be avoided. Avoiding antibiotic prophylaxis would reduce the costs and the potential risks of antibiotic resistance. MDPI 2022-10-07 /pmc/articles/PMC9611403/ /pubmed/36297568 http://dx.doi.org/10.3390/pharmaceutics14102133 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 Baudin, Florian Benzenine, Eric Mariet, Anne-Sophie Ghezala, Inès Ben Bron, Alain M. Daien, Vincent Gabrielle, Pierre-Henry Quantin, Catherine Creuzot-Garcher, Catherine Topical Antibiotic Prophylaxis and Intravitreal Injections: Impact on the Incidence of Acute Endophthalmitis—A Nationwide Study in France from 2009 to 2018 |
title | Topical Antibiotic Prophylaxis and Intravitreal Injections: Impact on the Incidence of Acute Endophthalmitis—A Nationwide Study in France from 2009 to 2018 |
title_full | Topical Antibiotic Prophylaxis and Intravitreal Injections: Impact on the Incidence of Acute Endophthalmitis—A Nationwide Study in France from 2009 to 2018 |
title_fullStr | Topical Antibiotic Prophylaxis and Intravitreal Injections: Impact on the Incidence of Acute Endophthalmitis—A Nationwide Study in France from 2009 to 2018 |
title_full_unstemmed | Topical Antibiotic Prophylaxis and Intravitreal Injections: Impact on the Incidence of Acute Endophthalmitis—A Nationwide Study in France from 2009 to 2018 |
title_short | Topical Antibiotic Prophylaxis and Intravitreal Injections: Impact on the Incidence of Acute Endophthalmitis—A Nationwide Study in France from 2009 to 2018 |
title_sort | topical antibiotic prophylaxis and intravitreal injections: impact on the incidence of acute endophthalmitis—a nationwide study in france from 2009 to 2018 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9611403/ https://www.ncbi.nlm.nih.gov/pubmed/36297568 http://dx.doi.org/10.3390/pharmaceutics14102133 |
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