Fusidic acid prophylaxis before cataract surgery: patient self-administration.
In a placebo-controlled, randomised, double-blind clinical trial, the authors evaluated the efficacy of patient-administered 1% fusidic acid viscous eye drops in clearing the commonest organisms causing pseudophakic endophthalmitis (Staphylococcus epidermidis and aureus) from the lids and conjunctivae of 79 patients before cataract surgery. The treatment group self-administered fusidic acid viscous eye drops four times daily for seven days before surgery; the placebo group received inert ophthalmic drops. Fellow eyes of both groups remained untreated as a natural control. Lower fornix and lid margin cultures were taken from both eyes before and after treatment. Before treatment, there was no statistical difference in organism counts between the groups. After treatment, eyes receiving fusidic acid were more likely to be free of clinically relevant Staphylococcus spp. than all pre-treatment eyes (for lids, P << 0.001; conjunctivae, P = 0.02). A highly significant (P < 0.001) number of lid margins were rendered 'clinically clean' (i.e., 0-49 organisms/swab) by fusidic acid when compared with untreated eyes. Treatment also effectively (P < 0.05) reduced the numbers of bacteria isolated from conjunctivae. This study indicates that there is a highly significant reduction of Staphylococcus spp. (P << 0.001), non-Staphylococcus spp. (P << 0.001) and attainment of sterile eyes (P << 0.001) at operation gained by patient self-administration of 1% fusidic acid four times daily for seven days before surgery.
Gray
T B
TB
Department of Ophthalmology, Christchurch School of Medicine, New Zealand.
Keenan
J I
JI
Clemett
R S
RS
Allardyce
R A
RA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D015169:Colony Count, Microbial; D003228:Conjunctiva / Q000382:microbiology; D004311:Double-Blind Method; D009877:Endophthalmitis / Q000382:microbiology / Q000517:prevention & control; D015818:Eye Infections, Bacterial / Q000517:prevention & control*; D005143:Eyelids / Q000382:microbiology; D005260:Female; D005672:Fusidic Acid / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011292:Premedication; D012646:Self Administration; D013210:Staphylococcus / Q000302:isolation & purification
D009883:Ophthalmic Solutions; D005672:Fusidic Acid