title: Prophylaxis of acute posttraumatic bacterial endophthalmitis: a multicenter, randomized clinical trial of intraocular antibiotic injection, report 2.
abstract: OBJECTIVE
  To evaluate the efficacy of intraocular gentamicin sulfate and clindamycin in the prevention of acute posttraumatic bacterial endophthalmitis following penetrating eye injuries.
  
  
  METHODS
  We conducted a multicenter, randomized, double-masked controlled trial of 346 eyes with penetrating eye injury. Following primary repair, eyes were randomized to intracameral or intravitreal injection of 40 microg of gentamicin sulfate and 45 microg of clindamycin (cases) vs balanced salt solution (controls).
  
  
  METHODS
  Occurrence of endophthalmitis within 2 weeks.
  
  
  RESULTS
  Endophthalmitis occurred in 8 (2.3%) of 167 eyes in the control group and only in 1 (0.3%) of 179 eyes in the case group (P = .04; odds ratio, 8.93 [95% confidence interval, 1.11-71.43]). In eyes with an intraocular foreign body, endophthalmitis developed in 7 of 25 control eyes and in none of 27 eyes receiving antibiotics. However, in eyes without an intraocular foreign body, endophthalmitis developed in 1 of 142 eyes and 1 of 152 eyes in the 2 groups, respectively (P value for interaction = .04). Intravitreal injection was superior to intracameral injection in preventing endophthalmitis (P value for interaction = .01). Vitreous culture results were positive in 6 (67%) of 9 eyes with endophthalmitis.
  
  
  CONCLUSIONS
  Intraocular gentamicin and clindamycin are effective in the prevention of acute posttraumatic bacterial endophthalmitis in eyes with retained intraocular foreign body.
  
  
  CONCLUSIONS
  Prophylaxis of traumatic endophthalmitis.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00398658.
authors.affiliation: Department of Ophthalmology and Ophthalmic Research Center, Labbafinejad Medical Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran. masoud_soheilian@yahoo.com
authors.forename: Masoud
authors.initials: M
authors.lastname: Soheilian
authors.forename: Nasrin
authors.initials: N
authors.lastname: Rafati
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Mohebbi
authors.forename: Shahin
authors.initials: S
authors.lastname: Yazdani
authors.forename: Houshang Faghihi
authors.initials: HF
authors.lastname: Habibabadi
authors.forename: Mostafa
authors.initials: M
authors.lastname: Feghhi
authors.forename: Hossein A
authors.initials: HA
authors.lastname: Shahriary
authors.forename: Jamil
authors.initials: J
authors.lastname: Eslamipour
authors.forename: Niloofar
authors.initials: N
authors.lastname: Piri
authors.forename: Gholam A
authors.initials: GA
authors.lastname: Peyman
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002981:Clindamycin / Q000627:therapeutic use; D004311:Double-Blind Method; D009877:Endophthalmitis / Q000382:microbiology / Q000517:prevention & control*; D005129:Eye Foreign Bodies / Q000150:complications; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000517:prevention & control*; D015807:Eye Injuries, Penetrating / Q000150:complications*; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D007267:Injections; D008297:Male; D011183:Postoperative Complications; D014822:Vitreous Body / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002981:Clindamycin