头孢呋辛预防白内障术后眼内炎的风险
Risks of Cefuroxime Prophylaxis for Postcataract Endophthalmitis.
作者信息
Al-Abduljabbar Khaled A, Stone Donald U
机构信息
Research Department, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saud Arabia.
College of Medicine, King Saud University, Riyadh, Kingdom of Saud Arabia.
出版信息
Middle East Afr J Ophthalmol. 2017 Jan-Mar;24(1):24-29. doi: 10.4103/meajo.MEAJO_255_16.
BACKGROUND
Endophthalmitis after cataract surgery is a rare but vision-threatening complication. Intracameral cefuroxime (ICC) has been reported to be effective at reducing the risk, but concerns regarding the risks associated with this intervention remain.
METHODS
Systematic review and synthesis of the literature on ICC, with a focus on the risks of therapy.
RESULTS
Level 2a evidence was found to support the use of cefuroxime in penicillin-allergic patients. Compounding or dilutional errors are associated with ocular toxicity, but the incidence and risk of this occurrence are unknown. Level 4 evidence supports interventions that reduce the risk of dilutional errors. The association of cefuroxime injection with toxic anterior segment syndrome (TASS) is not established; Level 5 evidence supports standard measures to reduce the incidence of TASS related to cefuroxime administration.
CONCLUSION
Cefuroxime can be administered safely to penicillin-allergic patients, and steps should be taken to reduce the risk of compounding or dilutional errors to avoid negating the benefits of this intervention. Recommended practice patterns for endophthalmitis prophylaxis should consider the risks and benefits of ICC.
背景
白内障手术后的眼内炎是一种罕见但会威胁视力的并发症。据报道，前房注射头孢呋辛（ICC）在降低风险方面有效，但对该干预措施相关风险的担忧依然存在。
方法
对关于ICC的文献进行系统综述和综合分析，重点关注治疗风险。
结果
发现有2a级证据支持在青霉素过敏患者中使用头孢呋辛。配制或稀释错误与眼毒性相关，但这种情况的发生率和风险尚不清楚。4级证据支持降低稀释错误风险的干预措施。头孢呋辛注射与毒性眼前节综合征（TASS）之间的关联尚未确立；5级证据支持采取标准措施以降低与头孢呋辛给药相关的TASS发生率。
结论
头孢呋辛可安全用于青霉素过敏患者，应采取措施降低配制或稀释错误的风险，以避免抵消该干预措施的益处。眼内炎预防的推荐实践模式应考虑ICC的风险和益处。
Zotero 插件