TY - JOUR
T1 - The Use of Preoperative Prophylactic Systemic Antibiotics for the Prevention of Endopthalmitis in Open Globe Injuries
T2 - A Meta-Analysis
AU - Patterson, Tim J.
AU - McKinney, David
AU - Ritson, Jonathan
AU - McLean, Chris
AU - Gu, Weidong
AU - Colyer, Marcus
AU - McClellan, Scott F.
AU - Miller, Sarah C.
AU - Justin, Grant A.
AU - Hoskin, Annette K.
AU - Cavuoto, Kara
AU - Leong, James
AU - Ascarza, Andrés Rousselot
AU - Woreta, Fasika A.
AU - Miller, Kyle E.
AU - Caldwell, Matthew C.
AU - Gensheimer, William G.
AU - Williamson, Tom
AU - Dhawahir-Scala, Felipe
AU - Shah, Peter
AU - Coombes, Andrew
AU - Sundar, Gangadhara
AU - Mazzoli, Robert A.
AU - Woodcock, Malcolm
AU - Kuhn, Ferenc
AU - Watson, Stephanie L.
AU - Gomes, Renata S.M.
AU - Agrawal, Rupesh
AU - Blanch, Richard J.
N1 - Publisher Copyright:
© 2023 American Academy of Ophthalmology
PY - 2023/11
Y1 - 2023/11
N2 - Topic: This study reports the effect of systemic prophylactic antibiotics (and their route) on the risk of endophthalmitis after open globe injury (OGI). Clinical Relevance: Endophthalmitis is a major complication of OGI; it can lead to rapid sight loss in the affected eye. The administration of systemic antibiotic prophylaxis is common practice in some health care systems, although there is no consensus on their use. Methods: PubMed, CENTRAL, Web of Science, CINAHL, and Embase were searched. This was completed July 6, 2021 and updated December 10, 2022. We included randomized and nonrandomized prospective studies which reported the rate of post-OGI endophthalmitis when systemic preoperative antibiotic prophylaxis (via the oral or IV route) was given. The Cochrane Risk of Bias tool and ROBINS-I tool were used for assessing the risk of bias. Where meta-analysis was performed, results were reported as an odds ratio. PROSPERO registration: CRD42021271271. Results: Three studies were included. One prospective observational study compared outcomes of patients who had received systemic or no systemic preoperative antibiotics. The endophthalmitis rates reported were 3.75% and 4.91% in the systemic and no systemic preoperative antibiotics groups, a nonsignificant difference (P = 0.68). Two randomized controlled trials were included (1555 patients). The rates of endophthalmitis were 17 events in 751 patients (2.26%) and 17 events in 804 patients (2.11%) in the oral antibiotics and IV (± oral) antibiotics groups, respectively. Meta-analysis demonstrated no significant differences between groups (odds ratio, 1.07; 95% confidence interval, 0.54–2.12). Conclusions: The incidences of endophthalmitis after OGI were low with and without systemic antibiotic prophylaxis, although high-risk cases were excluded in the included studies. When antibiotic prophylaxis is considered, there is moderate evidence that oral antibiotic administration is noninferior to IV. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
AB - Topic: This study reports the effect of systemic prophylactic antibiotics (and their route) on the risk of endophthalmitis after open globe injury (OGI). Clinical Relevance: Endophthalmitis is a major complication of OGI; it can lead to rapid sight loss in the affected eye. The administration of systemic antibiotic prophylaxis is common practice in some health care systems, although there is no consensus on their use. Methods: PubMed, CENTRAL, Web of Science, CINAHL, and Embase were searched. This was completed July 6, 2021 and updated December 10, 2022. We included randomized and nonrandomized prospective studies which reported the rate of post-OGI endophthalmitis when systemic preoperative antibiotic prophylaxis (via the oral or IV route) was given. The Cochrane Risk of Bias tool and ROBINS-I tool were used for assessing the risk of bias. Where meta-analysis was performed, results were reported as an odds ratio. PROSPERO registration: CRD42021271271. Results: Three studies were included. One prospective observational study compared outcomes of patients who had received systemic or no systemic preoperative antibiotics. The endophthalmitis rates reported were 3.75% and 4.91% in the systemic and no systemic preoperative antibiotics groups, a nonsignificant difference (P = 0.68). Two randomized controlled trials were included (1555 patients). The rates of endophthalmitis were 17 events in 751 patients (2.26%) and 17 events in 804 patients (2.11%) in the oral antibiotics and IV (± oral) antibiotics groups, respectively. Meta-analysis demonstrated no significant differences between groups (odds ratio, 1.07; 95% confidence interval, 0.54–2.12). Conclusions: The incidences of endophthalmitis after OGI were low with and without systemic antibiotic prophylaxis, although high-risk cases were excluded in the included studies. When antibiotic prophylaxis is considered, there is moderate evidence that oral antibiotic administration is noninferior to IV. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
KW - Antibiotics
KW - Endophthalmitis
KW - Open globe injury
KW - Prophylaxis
KW - Trauma
UR - https://www.scopus.com/pages/publications/85168001968
U2 - 10.1016/j.oret.2023.06.022
DO - 10.1016/j.oret.2023.06.022
M3 - Review article
C2 - 37406735
AN - SCOPUS:85168001968
SN - 2468-6530
VL - 7
SP - 972
EP - 981
JO - Ophthalmology Retina
JF - Ophthalmology Retina
IS - 11
ER -