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预防性前房内抗生素在白内障手术后预防眼内炎的疗效。

Efficacy of prophylactic intracameral antibiotic in preventing endophthalmitis after cataract surgery.

机构信息

Ophthalmology Department, Instituto de Assistência Médica ao Servidor Público Estadual, São Paulo, SP, Brazil.

出版信息

Arq Bras Oftalmol. 2024 Nov 22;88(3). doi: 10.5935/0004-2749.2023-0345. eCollection 2024.

Abstract

PURPOSE

To determine the impact of prophylactic intracameral cefuroxime administration on the post-cataract surgery endophthalmitis rates and analyze its safety.

METHODS

The incidence of post-phacoemulsification endophthalmitis before and after the introduction of antibiotic prophylaxis with cefuroxime was compared. Data were extracted from the electronic medical records of patients who underwent cataract surgery between July 2019 and July 2022 at a tertiary-care hospital. Data were also collected from the Hospital Infection Control Service database. Statistical analysis was performed to assess the efficacy of cefuroxime prophylaxis in reducing endophthalmitis rates.

RESULTS

Of the 4459 cataract surgeries included in the study, 2247 were included in the control group (pre-cefuroxime), and 2212 were included in the post-cefuroxime (ATB-P) Group. In the control group, 6 (0.13%) cases of endophthalmitis were reported. In the ATB-P Group, there were no cases of acute endophthalmitis. The frequency of endophthalmitis was significantly higher in the control group than in the ATB-P Group (p=0.016). Furthermore, Staphylococcus sp. was the most identified causative agent (75%). No adverse effects were reported after cefuroxime administration.

CONCLUSION

The introduction of intracameral prophylaxis with cefuroxime significantly reduced the incidence of post-cataract surgery endophthalmitis. Additionally, its administration is safe.

摘要

目的

确定预防性前房内注射头孢呋辛对白内障手术后眼内炎发生率的影响,并分析其安全性。

方法

比较了使用头孢呋辛进行抗生素预防前后白内障超声乳化术后眼内炎的发生率。从 2019 年 7 月至 2022 年 7 月在一家三级保健医院接受白内障手术的患者的电子病历中提取数据,并从医院感染控制服务数据库中收集数据。对头孢呋辛预防在降低眼内炎发生率方面的疗效进行了统计分析。

结果

在纳入研究的 4459 例白内障手术中,2247 例纳入对照组(头孢呋辛前),2212 例纳入头孢呋辛后(ATB-P)组。在对照组中,报告了 6 例(0.13%)眼内炎病例。在 ATB-P 组中,没有发生急性眼内炎。对照组的眼内炎发生率明显高于 ATB-P 组(p=0.016)。此外,葡萄球菌属是最常见的病原体(75%)。头孢呋辛给药后未报告不良反应。

结论

引入前房内头孢呋辛预防可显著降低白内障手术后眼内炎的发生率,且其给药安全。

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