title: Incidence of Endophthalmitis after Intravitreal Bevacizumab using Aliquots Prepared On-site in 2 Operating Rooms in Kuwait.
abstract: OBJECTIVE
  To report the incidence of endophthalmitis after intravitreal injection of bevacizumab and the outcomes of treatment of endophthalmitis at two centers in Kuwait.
  
  
  METHODS
  The aliquots of bevacizumab were prepared under aseptic precautions and administered in the operating theater on the same day at both centers. All patients received antibiotic drops after injection of bevacizumab. Data were collected on the number of cases that received intravitreal bevacizumab (IVB) and those that developed endophthalmitis were identified at the two centers. All cases of endophthalmitis received an intravitreal antibiotic injection and additional treatments as warranted. Data were collected on the outcomes of endophthalmitis treatment.
  
  
  RESULTS
  There were 5 cases of endophthalmitis among a total of 5429 injections (0.09%: Confidence interval: 0.084-0.1). The incidence was 3 cases among 4690 (0.06%) and 2 cases among 739 injections (0.027%) at each center, respectively (P = 0.08). Four cases of endophthalmitis were culture-positive and organisms isolated were, coagulase negative Staphylococcus in 2 cases, Staphylococcus lugdunensis and Streptococcus pneumoniae in 1 case each. The final visual acuity was better than pre-IVB in 3 cases, same as pre-IVB in 1 case and worse in 1 case with streptococcal infection. No eyes developed phthisis bulbi or required enucleation.
  
  
  CONCLUSIONS
  The incidence of endophthalmitis after intravitreal injection of bevacizumab using aliquots prepared in the operating room is comparable to other studies. There were no clusters of endophthalmitis cases.
authors.affiliation: Department of Ophthalmology, Al-Adan Hospital, Hadiya, Kuwait; Al-Bahar Ophthalmology Center, Shuwaikh, Kuwait.
authors.forename: Vivek B
authors.initials: VB
authors.lastname: Wani
authors.affiliation: Al-Bahar Ophthalmology Center, Shuwaikh, Kuwait.
authors.forename: Jamal
authors.initials: J
authors.lastname: Al-Kandari
authors.affiliation: Al-Bahar Ophthalmology Center, Shuwaikh, Kuwait.
authors.forename: Khalid
authors.initials: K
authors.lastname: Sabti
authors.affiliation: Al-Bahar Ophthalmology Center, Shuwaikh, Kuwait.
authors.forename: Faisal
authors.initials: F
authors.lastname: Aljassar
authors.affiliation: Al-Bahar Ophthalmology Center, Shuwaikh, Kuwait.
authors.forename: Hussain
authors.initials: H
authors.lastname: Qali
authors.affiliation: Al-Bahar Ophthalmology Center, Shuwaikh, Kuwait.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Department of Ophthalmology, Al-Adan Hospital, Hadiya, Kuwait.
authors.forename: Anilkumar
authors.initials: A
authors.lastname: Uboweja
authors.affiliation: Al-Bahar Ophthalmology Center, Shuwaikh, Kuwait.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Sabah
authors.affiliation: Al-Bahar Ophthalmology Center, Shuwaikh, Kuwait.
authors.forename: Fahad A
authors.initials: FA
authors.lastname: Diab
authors.affiliation: Al-Bahar Ophthalmology Center, Shuwaikh, Kuwait.
authors.forename: Saleh
authors.initials: S
authors.lastname: Al-Rashidi
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000737:chemistry / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000068258:Bevacizumab / Q000737:chemistry / Q000627:therapeutic use*; D004339:Drug Compounding; D009877:Endophthalmitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections; D007730:Kuwait / Q000453:epidemiology; D008268:Macular Degeneration / Q000188:drug therapy; D008269:Macular Edema / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D057787:Staphylococcus lugdunensis / Q000302:isolation & purification; D013290:Streptococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D000900:Anti-Bacterial Agents; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab
keywords: Anti-vascular Endothelial Growth Factor; Bevacizumab; Endophthalmitis; Incidence; Intravitreal