Incidence of Endophthalmitis after Intravitreal Bevacizumab using Aliquots Prepared On-site in 2 Operating Rooms in Kuwait

• Published in: Middle East African journal of ophthalmology 2016-01, Vol.23 (1), p.64-70
• Main Authors: Wani, Vivek B, Al-Kandari, Jamal, Sabti, Khalid, Aljassar, Faisal, Qali, Hussain, Kumar, Niranjan, Uboweja, Anilkumar, Al-Sabah, Khalid, Diab, Fahad A, Al-Rashidi, Saleh
• Format: Article
• Language: English
• Subjects: Aged; Angiogenesis Inhibitors - chemistry; Angiogenesis Inhibitors - therapeutic use; Anti-Bacterial Agents - therapeutic use; Bevacizumab; Bevacizumab - chemistry; Bevacizumab - therapeutic use; Care and treatment; Complications and side effects; Dosage and administration; Drug Compounding; Endophthalmitis; Endophthalmitis - drug therapy; Endophthalmitis - epidemiology; Endophthalmitis - microbiology; Eye Infections, Bacterial - drug therapy; Eye Infections, Bacterial - epidemiology; Eye Infections, Bacterial - microbiology; Female; Humans; Incidence; Intravitreal Injections; Kuwait - epidemiology; Macular Degeneration - drug therapy; Macular Edema - drug therapy; Male; Middle Aged; Operating Rooms; Original; Pneumococcal Infections - drug therapy; Pneumococcal Infections - epidemiology; Pneumococcal Infections - microbiology; Retrospective Studies; Risk factors; Staphylococcus lugdunensis - isolation & purification; Streptococcal Infections - drug therapy; Streptococcal Infections - epidemiology; Streptococcal Infections - microbiology; Streptococcus pneumoniae - isolation & purification; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual Acuity
• ISSN: 0974-9233; 0975-1599; 0975-1599; 0974-9233
• DOI: 10.4103/0974-9233.171784

To report the incidence of endophthalmitis after intravitreal injection of bevacizumab and the outcomes of treatment of endophthalmitis at two centers in Kuwait. 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. 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. 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.