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Intracameral antibiotics work

机译：前房内抗生素的工作

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LAYING OUT THE EVIDENCEStudies with multiple antibiotics in varied settings have demonstrated the benefit of intracamerals. The European Society of Cataract and Refractive Surgery performed a multinational study of 16,600 patients prospectively randomized to intracameral cefuroxime and topical levofloxacin. Cefuroxime reduced endophthalmitis risk five-fold, and patients received no benefit from levofloxacin eyedrops.8 A 16,000-patient study in California showed a 22-fold reduction in endophthalmitis using a combination of cefuroxime (84%), moxifloxacin (15%), and vancomycin (1%).9 Studies in Spain and Sweden also strongly support cefuroxime.10-12Moxifloxacin provides broader coverage against bacteria than cefuroxime, and studies have also demonstrated its effectiveness. Aravind Eye Hospital introduced intracameral moxifloxacin after manual small incision cataract surgery in its charity patients. The rate in the 38,000 patients postmoxifloxacin (0.02%) was significantly less than the rate in the 38,000 patients premoxifloxacin (0.08%, p<0.0001).13 This four-fold reduction occurred despite a significantly higher complication rate, a known risk factor for endophthalmitis, in the moxifloxacin group. The 0.02% rate was also lower than a group of private patients who did not receive intracameral antibiotics even though 79% of the private pay group had phacoemulsification (0.07%, p<0.0001). Similar reductions have been found after phacoemulsification in Japan (0.05% to 0.016%).14Intracameral cefazolin reduced the endophthalmitis rate from 0.42% to 0.047% in Spain.15 Vancomycin decreased the rate from 0.097% to 0% (P=0.0015) at an ASC in Texas, and it also reduced endophthalmitis cases at a hospital in Australia (0.43% to 0.049%, P<0.0001).16,17On the other hand, postoperative topical antibiotics, used by 97% of ophthalmologists, have not been proven to prevent endophthalmitis.
机译：制定证据研究在多种环境中使用多种抗生素的研究已证明前房内药物的益处。欧洲白内障和屈光手术学会对16600名患者进行了一项多国研究，这些患者前瞻性随机分为小儿头孢呋辛和局部左氧氟沙星。头孢呋辛将眼内炎的风险降低了五倍，并且左氧氟沙星滴眼液未给患者带来任何益处。8在加利福尼亚的一项16,000名患者的研究显示，使用头孢呋辛（84％），莫西沙星（15％）和头孢呋辛联合使用可减少22倍的眼内炎。万古霉素（1％）。9在西班牙和瑞典的研究也强烈支持头孢呋辛。10-12莫西沙星比头孢呋辛对细菌的作用更广，研究也证明了它的有效性。 Aravind眼科医院对其慈善患者进行了手动小切口白内障手术后介绍了前房内莫西沙星治疗。在38,000例莫西沙星后患者中的发生率（0.02％）显着低于38,000例莫西沙星前患者中的发生率（0.08％，p <0.0001）。13尽管并发症发生率显着提高，但这种降低是四倍，这是已知的危险因素眼内炎，莫西沙星组。 0.02％的比率也低于未接受前房内抗生素治疗的私人患者组，即使私人付费组中有79％进行了超声乳化术（0.07％，p <0.0001）。在日本进行超声乳化手术后也发现了类似的减少（0.05％至0.016％）。14西班牙的房前头孢唑啉将眼内炎的发生率从0.42％降低至0.047％。15万古霉素在90％的使用率从0.097％降低至0％（P = 0.0015）。得克萨斯州的ASC，并且还减少了澳大利亚一家医院的眼内炎病例（0.43％至0.049％，P <0.0001）。16,17另一方面，尚未被97％的眼科医生使用术后局部抗生素预防眼内炎。

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