title: Comparison of 1-day versus 1-hour application of topical neomycin/polymyxin-B before cataract surgery.
abstract: OBJECTIVE
  To compare the efficacy of 2 prophylaxis regimens before cataract surgery using topical antibiotics (1 hour before surgery versus the day before), both with povidone-iodine, with regard to reducing the preoperative conjunctival bacterial load.
  
  
  METHODS
  Tertiary ophthalmic referral center, Munich, Germany.
  
  
  METHODS
  Prospective comparative case series.
  
  
  METHODS
  Eyes were treated with topical antibiotics and their conjunctival sac flush irrigated using 10 mL of povidone-iodine 1.0%. All eyes were randomized to receive either 4 applications of topical 3500 IU/mL neomycin sulfate/6000 IU/mL polymyxin-B sulfate within 1 hour preoperatively (Group 1) or on the day before surgery (Group 2). Conjunctival specimens were obtained at 4 timepoints: T0C untreated fellow eye (control), T0 surgery eye (after antibiotic prophylaxis but before povidone-iodine irrigation), T1 after povidone-iodine, and T2 at the conclusion of surgery. All specimens were inoculated onto blood and chocolate-blood agar and into thioglycollate broth.
  
  
  RESULTS
  One hundred thirty-three eyes of 133 consecutive patients were included (Group 1, 64 eyes; Group 2, 69 eyes). The antibiotic regimens were equally effective in reducing the aerobic and microaerophilic conjunctival flora (Group 1, P=.028; Group 2, P=.000), but had no significant effect on anaerobic bacteria (Group 1, P=.201; Group 2, P=.117). Flush irrigation of the conjunctival sac using 10.0 mL povidone-iodine 1.0% significantly decreased the conjunctival bacterial load in both groups.
  
  
  CONCLUSIONS
  Topical neomycin/polymyxin-B was equally effective in reducing the conjunctival bacterial load whether given 1 day or 1 hour before surgery. The greatest effect was achieved by irrigating the conjunctival sac using povidone-iodine.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology (Li, Miño de Kaspar, Haritoglou, Kook, Kampik, Nentwich), Ludwig-Maximilians University, Munich, Germany; the Department of Ophthalmology (Li, Sheng), Yangpu Hospital, Tongji University, Shanghai, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.affiliation: From the Department of Ophthalmology (Li, Miño de Kaspar, Haritoglou, Kook, Kampik, Nentwich), Ludwig-Maximilians University, Munich, Germany; the Department of Ophthalmology (Li, Sheng), Yangpu Hospital, Tongji University, Shanghai, China.
authors.forename: Herminia
authors.initials: H
authors.lastname: Miño de Kaspar
authors.affiliation: From the Department of Ophthalmology (Li, Miño de Kaspar, Haritoglou, Kook, Kampik, Nentwich), Ludwig-Maximilians University, Munich, Germany; the Department of Ophthalmology (Li, Sheng), Yangpu Hospital, Tongji University, Shanghai, China.
authors.forename: Christos
authors.initials: C
authors.lastname: Haritoglou
authors.affiliation: From the Department of Ophthalmology (Li, Miño de Kaspar, Haritoglou, Kook, Kampik, Nentwich), Ludwig-Maximilians University, Munich, Germany; the Department of Ophthalmology (Li, Sheng), Yangpu Hospital, Tongji University, Shanghai, China.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kook
authors.affiliation: From the Department of Ophthalmology (Li, Miño de Kaspar, Haritoglou, Kook, Kampik, Nentwich), Ludwig-Maximilians University, Munich, Germany; the Department of Ophthalmology (Li, Sheng), Yangpu Hospital, Tongji University, Shanghai, China.
authors.forename: Anselm
authors.initials: A
authors.lastname: Kampik
authors.affiliation: From the Department of Ophthalmology (Li, Miño de Kaspar, Haritoglou, Kook, Kampik, Nentwich), Ludwig-Maximilians University, Munich, Germany; the Department of Ophthalmology (Li, Sheng), Yangpu Hospital, Tongji University, Shanghai, China.
authors.forename: Minjie
authors.initials: M
authors.lastname: Sheng
authors.affiliation: From the Department of Ophthalmology (Li, Miño de Kaspar, Haritoglou, Kook, Kampik, Nentwich), Ludwig-Maximilians University, Munich, Germany; the Department of Ophthalmology (Li, Sheng), Yangpu Hospital, Tongji University, Shanghai, China. Electronic address: martin.nentwich@med.uni-muenchen.de.
authors.forename: Martin M
authors.initials: MM
authors.lastname: Nentwich
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D001419:Bacteria / Q000302:isolation & purification; D058491:Bacterial Load; D003228:Conjunctiva / Q000382:microbiology; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009355:Neomycin / Q000008:administration & dosage*; D018918:Phacoemulsification; D011112:Polymyxin B / Q000008:administration & dosage*; D011206:Povidone-Iodine / Q000008:administration & dosage; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D011206:Povidone-Iodine; D009355:Neomycin; D011112:Polymyxin B