title: Adherence to European Society for Cataract and Refractive Surgery recommendations among Italian cataract surgeons: a survey.
abstract: OBJECTIVE
  To survey the surgical routines with regards to prophylactic strategies in a sample of Italian hospitals and compare these with European Society for Cataract and Refractive Surgery (ESCRS) guidelines.
  
  
  METHODS
  Six private and 18 public hospitals were included in this clinical-based retrospective study. The overall volume of cataract operations in the 24 centers in 2013 was 43,553. Main outcome measure was incidence of endophthalmitis per 1,000. An incidence of less than 0.13% was considered acceptable.
  
  
  RESULTS
  Our study provides the first Italian data on the use of intracameral antibiotics in cataract surgery as recommended by the ESCRS. Thirteen centers (54%) used intracameral cefuroxime at the end of surgery. Of the 13 centers that used cefuroxime, 8 (62%) had an incidence of endophthalmitis less than 0.13%. Of the 7 (29%) centers that did not use intracameral cefuroxime, all had an endophthalmitis rate of greater than 0.13%. This difference was statistically significant (p&lt;0.05). Among the 4 centers not included, 2 used vancomycin in the infusion bottle, 1 a fluoroquinolone, and the last a combination of antibiotics. The majority of surgeons (71%) used preoperative antibiotic eyedrops, but this measure was not shown to be significantly protective.
  
  
  CONCLUSIONS
  Slightly more than half of the centers surveyed in this study adhered to the recommendations of the ESCRS and routinely employed prophylactic intracameral cefuroxime. An incidence of endophthalmitis greater than 0.13% was encountered significantly more frequently among centers that did not employ intracameral cefuroxime.
authors: Centre for Macular Research and Allied Diseases, San Mauro, Torinese (Turin) - Italy.
authors: Andrea
authors: A
authors: Grosso
authors: Sacro Cuore Don Calabria Hospital, Negrar, Verona - Italy.
authors: Grazia
authors: G
authors: Pertile
authors: Borgo Trento Hospital, University of Verona, Verona - Italy.
authors: Giorgio
authors: G
authors: Marchini
authors: Head Ophthalmology Department, Regional Hospital 'Ca Foncello', Ulss Veneto Region, Treviso - Italy.
authors: Giuseppe
authors: G
authors: Scarpa
authors: Borgo Trento Hospital, University of Verona, Verona - Italy.
authors: Piero
authors: P
authors: Ceruti
authors: Sacro Cuore Don Calabria Hospital, Negrar, Verona - Italy.
authors: Guido
authors: G
authors: Prigione
authors: Department of Neuroscience, University Federico II, Naples - Italy.
authors: Mario R
authors: MR
authors: Romano
authors: Department of Public Health Sciences, University of Turin, Turin - Italy.
authors: Fabrizio
authors: F
authors: Bert
authors: Department of Public Health Sciences, University of Turin, Turin - Italy.
authors: Renata
authors: R
authors: Gili
authors: Department of Ophthalmology, Turin Eye Hospital, Turin - Italy.
authors: Claudio
authors: C
authors: Panico
authors: Department of Public Health Sciences, University of Turin, Turin - Italy.
authors: Roberta
authors: R
authors: Siliquini
authors: NYU School of Medicine and Vitreous Retina Macula Consultants of New York, P.C., New York - USA.
authors: Michael
authors: M
authors: Engelbert
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D002387:Cataract Extraction / Q000592:standards*; D002444:Cefuroxime / Q000627:therapeutic use*; D009877:Endophthalmitis / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007558:Italy; D008297:Male; D000072163:Ophthalmologists / Q000592:standards*; D009885:Ophthalmology / Q000458:organization & administration; D017410:Practice Guidelines as Topic / Q000592:standards*; D054140:Refractive Surgical Procedures / Q000592:standards*; D012189:Retrospective Studies; D012955:Societies, Medical / Q000592:standards; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D002444:Cefuroxime