Perioperative Antibiotics to Prevent Acute Endophthalmitis after Ophthalmic Surgery: A Systematic Review and Meta-Analysis

Post-operative endophthalmitis is a rare and dreaded complication in ophthalmic operations because it often induces irreparable vision loss. Although many ophthalmological studies aimed at reducing the rate of endophthalmitis have been performed around the world, controversy continues to surround so...

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Bibliographic Details
Published in:PloS one 2016-11, Vol.11 (11), p.e0166141-e0166141
Main Authors: Huang, Jinzhu, Wang, Xiaofang, Chen, Xiaohong, Song, Qiuyue, Liu, Wen, Lu, Laichun
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Analysis
Anterior Chamber - microbiology
Anterior Chamber - surgery
Anti-Bacterial Agents - therapeutic use
Antibiotics
Antimicrobial agents
Bacteria
Biology and Life Sciences
Cataract Extraction - adverse effects
Cataracts
Cefuroxime
Clinical outcomes
Clinical trials
Confidence intervals
Drug resistance
Endophthalmitis
Endophthalmitis - prevention & control
Enterococcus
Eye
Eye (anatomy)
Eye Infections, Bacterial - prevention & control
Eye surgery
Female
Hospitals
Humans
Iodine
Laboratories
Male
Medical personnel
Medical research
Medicine and Health Sciences
Meta-analysis
Microorganisms
Moxifloxacin
Observational Studies as Topic
Perioperative Care - methods
Pharmacy
Physical Sciences
Postoperative Complications - prevention & control
Randomization
Randomized Controlled Trials as Topic
Research and Analysis Methods
Staphylococcus
Statistical analysis
Statistical significance
Studies
Surgery
Systematic review
Vancomycin
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Summary:Post-operative endophthalmitis is a rare and dreaded complication in ophthalmic operations because it often induces irreparable vision loss. Although many ophthalmological studies aimed at reducing the rate of endophthalmitis have been performed around the world, controversy continues to surround some issues, including the choice of antimicrobials and their route of administration, duration and timing. The aim of this study is to investigate some of these unresolved issues. A systematic review and meta-analysis of randomized controlled trials and observational studies was performed. The PubMed, EMBASE, Cochrane Library and Clinical Trials databases were searched to identify studies published until Feb. 2016. The relative risk (RR) for each clinical outcome data is presented with 95% confidence intervals (CIs). Pooled estimates of effects were calculated using random-effect models. Thirty-four studies from twenty-four reports involving 1264797 eyes were included in this analysis. Endophthalmitis occurred, on average, in one out of 6177 eyes when intracameral vancomycin/moxifloxacin were used and in one out of 1517 eyes when intracameral vancomycin/moxifloxacin were not used. The relative risk (95% CI) of endophthalmitis was reduced to 0.20 (0.10, 0.42) when intracameral antibiotics were used (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0166141