Is the Use of Topical Antibiotics for Intravitreal Injections the Standard of Care or Are We Better Off Without Antibiotics?

2013 ◽  
Vol 131 (7) ◽  
pp. 840 ◽  
Author(s):  
Royce W. S. Chen ◽  
Aleksandra Rachitskaya ◽  
Ingrid U. Scott ◽  
Harry W. Flynn
Keyword(s):  
Standard Of Care ◽  
Intravitreal Injections ◽  
Topical Antibiotics

scholarly journals Topical antibiotics and intravitreal injections

2017 ◽  
Vol 96 (5) ◽  
pp. 435-441 ◽  
Author(s):  
Alex P. Hunyor ◽  
Rohan Merani ◽  
Archie Darbar ◽  
Jean-François Korobelnik ◽  
Paolo Lanzetta ◽  
...  
Keyword(s):  
Intravitreal Injections ◽  
Topical Antibiotics

scholarly journals Disrupting the biofilm matrix improves wound healing outcomes

2015 ◽  
Vol 24 (8) ◽  
pp. 366-371 ◽  
Author(s):  
R. Wolcott
Keyword(s):  
Wound Healing ◽  
Extracellular Polymeric Substances ◽  
Wound Care ◽  
Controlled Trial ◽  
Standard Of Care ◽  
Surrogate Endpoint ◽  
Topical Antibiotics ◽  
Slime Layer ◽  
The Matrix ◽  
Biofilm Matrix

Objective: The most unyielding molecular component of biofilm communities is the matrix structure that it can create around the individual microbes that constitute the biofilm. The type of polymeric substances (polymeric sugars, bacterial proteins, bacterial DNA and even co-opted host substances) are dependent on the microbial species present within the biofilm. The extracellular polymeric substances that make up the matrix give the wound biofilm incredible colony defences against host immunity, host healing and wound care treatments. This polymeric slime layer, which is secreted by bacteria, encases the population of microbes, creating a physical barrier that limits the ingress of treatment agents to the bacteria. The aim of this study was to determine if degrading the wound biofilm matrix would improve wound healing outcomes and if so, if there was a synergy between treating agents that disrupted biofilm defenses with Next Science Wound Gel (wound gel) and cidal agents (topical antibiotics). Method: A three-armed randomised controlled trial was designed to determine if standard of care (SOC) was superior to SOC plus wound gel (SOC + gel) and wound gel alone. The wound gel used in this study contains components that directly attack the biofilm extracellular polymeric substance. The gel was applied directly to the wound bed on a Monday–Wednesday–Friday interval, either alone or with SOC topical antibiotics. Results: Using a surrogate endpoint of 50% reduction in wound volume, the results showed that SOC healed at 53%, wound gel healed at 80%, while SOC plus wound gel showed 93% of wounds being successfully treated. Conclusion: By directly targeting the wound biofilm matrix, wound healing outcomes are improved.

scholarly journals The role of preventive topical antibiotic treatment prior to intravitreal injection

2015 ◽  
Vol 8 (2) ◽  
pp. 79-83 ◽  
Author(s):  
Elena Vladimirovna Ageeva ◽  
Anna Evgen'yevna Grodnenskaya ◽  
Kseniya Aleksandrovna Popova
Keyword(s):  
Macular Degeneration ◽  
Intravitreal Injection ◽  
Staphylococcus Epidermidis ◽  
Povidone Iodine ◽  
Antibiotic Use ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Topical Antibiotic ◽  
Topical Antibiotics ◽  
Age Related

Treatment of wet age-related macular degeneration (AMD) requires frequent intravitreal injections of anti-VEGF agents, sometimes on monthly basis during a long period of time. Endophthalmitis is a rare but extremely severe complication of intravitreal injections. As it has been proven before, the flora from the conjunctival surface is the main source for endophthalmitis. Using Povidone-iodine solution (Betadine10 % Povidone-iodine, EGIS PHARMACEUTICALS) is the only way to prevent endophthalmitis. The efficacy of it was proven by numerous studies. No evidence exists that topical antibiotiotics prior and after injections could be effective for prevention of endophthalmitis. Purpose: To study the advisability of topical antibiotic application before intravitreal injection. Materials and methods: Under investigation, there were 25 eyes of 25 patients with wet AMD treated by anti-VEGF intravitreal injections. All patients used topical antibiotics 3 days before injection. Conjunctival culture from injection eye was collected three times: before topical antibiotic use; after topical antibiotic use, and after Betadine 5 % application. Results: The rates of Staphylococcus epidermidis before and after topical antibiotic use were approximately equal. However there was no Staphylococcus epidermidis found after Betadine 5 % application. Conclusion: Our study showed the effectiveness of Betadine 5 % solution in conjunctival flora reduction. Use of topical antibiotics 3 days prior intravitreal injections is not effective. Key words: age-related macular degeneration; endophthalmitis; intravitreal injection; topical antibiotics; endophthalmitis prevention.

Controversies in Topical Antibiotics Use with Intravitreal Injections

2015 ◽  
Vol 21 (32) ◽  
pp. 4703-4706 ◽  
Author(s):  
Stephen Schwartz ◽  
Harry Flynn ◽  
Andrzej Grzybowski
Keyword(s):  
Intravitreal Injections ◽  
Topical Antibiotics ◽  
Antibiotics Use

Incidence of endophthalmitis after intravitreal injection with and without topical antibiotic prophylaxis

2020 ◽  
pp. 112067212090202 ◽  
Author(s):  
Sónia Torres-Costa ◽  
Diogo Ramos ◽  
Elisete Brandão ◽  
Ângela Carneiro ◽  
Vítor Rosas ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Antibiotic Prophylaxis ◽  
Incidence Rate ◽  
Intravitreal Injection ◽  
Incidence Rates ◽  
Intravitreal Injections ◽  
Topical Antibiotic ◽  
Retrospective Case ◽  
Topical Antibiotics ◽  
Number Of Patients

Purpose: The purpose was to compare the incidence of endophthalmitis after intravitreal injection with and without topical antibiotic prophylaxis. Methods: This is a single-center, retrospective case–control study. All patients treated with intravitreal injection of ranibizumab, bevacizumab, aflibercept, or corticosteroids for a variety of retinal vascular diseases between 1 October 2014 and 30 November 2018 were included. The total number of patients and injections were determined from a review of billing code and practice management records. Endophthalmitis cases were determined from billing records and then confirmed with chart review. A 24-month period when topical antibiotics were prescribed after intravitreal injection was compared with a 24-month period when topical antibiotics were not prescribed. Results: Between 1 October 2014 and 30 November 2018, a total of 33,515 intravitreal injections were performed and 13 cases of post–intravitreal injection endophthalmitis were identified (incidence rate of 0.0388%; 95% confidence interval, 0.0217%–0.0644%) or approximately 1 case for every 2578 intravitreal injections. Between 1 October 2014 and 31 October 2016, while topical antibiotic prophylaxis was used postoperatively, 14,828 intravitreal injections were performed and 5 cases of endophthalmitis were reported (0.0337%; 95% confidence interval, 0.0129%–0.0739%). Between 1 November 2016 and 30 November 2018, while no prophylaxis was used, 18,687 intravitreal injections were performed and 8 cases of endophthalmitis were identified (0.0428%; 95% confidence interval, 0.0202%–0.0808%). There were no statistical differences in the incidence rates between the two groups ( p = 0.675). Conclusion: The incidence rate of endophthalmitis in the group with topical antibiotic prophylaxis after intravitreal injection was similar to the group with no prophylaxis. Changing the current clinical practice to no antibiotic prophylaxis had no effect on the incidence of endophthalmitis.

231: Laparoscopic Nephrectomy: Prolonged Diffusion of a Standard of Care

2006 ◽  
Vol 175 (4S) ◽  
pp. 77-77
Author(s):  
David C. Miller ◽  
John T. Wei ◽  
Brent K. Hollenbeck
Keyword(s):  
Standard Of Care ◽  
Laparoscopic Nephrectomy
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