Figurska Małgorzata
Kliniki Okulistyki Wojskowego Instytutu Medycznego w Warszawie.
Klin Oczna. 2011;113(1-3):38-41.
Endophthalmitis is one of the most dangerous complications after intravitreous drug injection. Preparing a patient to the injection general and topical endophtalmitis development risk factors should be eliminated. Antibiotic injection prophylaxis is still an important issue.
This research has to evaluate effectiveness and tolerance of Azithromycin (Azyter, Thea), in injection as an antibiotic prophylaxis in patients suffering from age-related macular degeneration (AMD).
The study was conducted in Ophtalmology Department (Medical Military Institute, Warsaw, Poland), in the group of 52 patients, who underwent 52 intraocular injections of anti-VEGF because of AMD. Topical Azithromycin had been administrated twice a day to both eyes in 2 days before injection. On the third day injection was performed in aseptic conditions. One drop of Azithromycin had been administrated to each eye directly before injection and one drop after the procedure. At that moment antibiotic prophylaxis was terminated.
Topical tolerance and effectiveness were evaluated. In 2 cases (3.8%) intensive allergic reaction was reported (significant conjuctives oedema, itch, bloodshot), what caused change of antibiotic. In 5 cases (9%) light bloodshot was reported. 12 patients (23%) reported light or moderate foreign body sensation and in 2 cases (3.8%) the sensation was significant. No reaction of ophthalmic inflammation was reported 5 days after injection, moreover foreign body sensation and bloodshot were absent. 30 patients (57%) were satisfied with new and simplier scheme of antibiotic injection prophylaxis (twice a day for 3 days).
Azithromycin is a comfortable alternative for other topical antibiotics, especially in repetitive procedures like anti-VEGF injections. High Azithromycin concentration in tissues, tear film, and on the ophthalmic surface, protects injection site and inhibits growth of primary and mutual bacterial colonies. Short-term exposition to Azithromycin decrases risk of drug resistance development.
眼内炎是玻璃体内药物注射后最危险的并发症之一。应消除患者注射时全身及局部发生眼内炎的危险因素。抗生素注射预防仍是一个重要问题。
本研究旨在评估阿奇霉素（Azyter，Thea）注射液作为年龄相关性黄斑变性（AMD）患者抗生素预防用药的有效性和耐受性。
该研究在波兰华沙军事医学研究所眼科进行，纳入52例因AMD接受52次抗VEGF眼内注射的患者。在注射前2天，每天双眼局部使用阿奇霉素2次。第3天在无菌条件下进行注射。注射前每只眼直接滴1滴阿奇霉素，注射后再滴1滴。此时抗生素预防结束。
评估局部耐受性和有效性。2例（3.8%）报告有强烈过敏反应（明显的结膜水肿、瘙痒、充血），因此更换了抗生素。5例（9%）报告有轻度充血。12例（23%）报告有轻度或中度异物感，2例（3.8%）异物感明显。注射后5天未报告眼部炎症反应，且无异物感和充血。30例（57%）患者对新的、更简单的抗生素注射预防方案（3天每天2次）感到满意。
阿奇霉素是其他局部用抗生素的一种舒适替代药物，尤其适用于抗VEGF注射等重复性操作。组织、泪膜和眼表中高浓度的阿奇霉素可保护注射部位并抑制原发性和共生菌落的生长。短期接触阿奇霉素可降低耐药性发展风险。
