[Intravitreal injection of antibiotics in endophthalmitis].
Early diagnosis and appropriate treatment with intravitreous antibiotics are the most important factors for the successful management of endophthalmitis. The intraocular concentration of antibiotics after intravitreous injection is far greater than that achieved by any other modality. The organisms in postoperative endophthalmitis are usually Gram-positive cocci and less commonly Gram-negative bacteria. Drug combinations are necessary to cover the full range of bacteria causing endophthalmitis. Vancomycin (1 mg/0.1 ml) is considered the drug of choice for Gram-positive organisms. Controversy remains concerning the best choice against Gram-negative bacteria. Aminoglycosides (amikacin, 0.4 mg/0.1 ml) have traditionally been recommended for Gram-negative coverage. However, because of their possible role in macular toxicity, recent trends have shifted to using ceftazidime (2.25 mg/0.1 ml) in combination with vancomycin.
Cornut
P-L
PL
Service d'ophtalmologie, Hospices civils de Lyon, Hôpital E. Herriot, Université Lyon I, Lyon.
Chiquet
C
C
D000617:Aminoglycosides / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001813:Blood-Retinal Barrier; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000188:drug therapy* / Q000601:surgery; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000627:therapeutic use; D006020:Glycopeptides / Q000008:administration & dosage / Q000627:therapeutic use; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006207:Half-Life; D006801:Humans; D007267:Injections; D012163:Retinal Detachment / Q000209:etiology / Q000517:prevention & control; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use; D014821:Vitrectomy; D014822:Vitreous Body
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D002511:Cephalosporins; D024841:Fluoroquinolones; D006020:Glycopeptides; D014640:Vancomycin