The Use of Preoperative Prophylactic Systemic Antibiotics for the Prevention of Endopthalmitis in Open Globe Injuries: A Meta-Analysis.

Autor:	Patterson TJ; Northern Ireland Medical and Dental Training Agency (NIMDTA), Belfast., McKinney D; Northern Ireland Medical and Dental Training Agency (NIMDTA), Belfast., Ritson J; Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom; Royal Centre for Defence Medicine, Birmingham, United Kingdom., McLean C; Epsom and St Helier University Hospitals NHS Trust, Carshalton, United Kingdom., Gu W; Vision Center of Excellence, Research & Development Directorate, J-9, Defence Health Agency, Silver Spring, Maryland., Colyer M; Uniformed Services University of the Health Sciences, Bethesda, Maryland., McClellan SF; Vision Center of Excellence, Research & Development Directorate, J-9, Defence Health Agency, Silver Spring, Maryland., Miller SC; Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland., Justin GA; Uniformed Services University of the Health Sciences, Bethesda, Maryland; Duke Eye Center, Duke University Hospitals, Durham, North Carolina., Hoskin AK; The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, New South Wales, Australia; Lions Eye Institute, University of Western Australia, Perth, Australia., Cavuoto K; Bascom Palmer Eye Institute, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida., Leong J; The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, New South Wales, Australia; The University of Sydney, Save Sight Institute, Faculty of Medicine and Health, Sydney, NSW, Australia., Ascarza AR; Consultorios Oftalmológicos Benisek-Ascarza, Ciudad Autónoma de Buenos Aires, C1115ABB Buenos Aires, Argentina., Woreta FA; Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland., Miller KE; Uniformed Services University of the Health Sciences, Bethesda, Maryland; Department of Ophthalmology, Navy Medical Center Portsmouth, Portsmouth, Virginia., Caldwell MC; Department of Ophthalmology, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas., Gensheimer WG; Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; White River Junction Veterans Administration Medical Center, White River Junction, Vermont., Williamson T; Department of Ophthalmology, St Thomas Hospital, London, United Kingdom., Dhawahir-Scala F; Manchester Royal Eye Hospital, Manchester, United Kingdom., Shah P; Birmingham Institute for Glaucoma Research, Birmingham, United Kingdom; Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom., Coombes A; Department of Ophthalmology, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, United Kingdom., Sundar G; Department of Ophthalmology, National University Hospital, Singapore., Mazzoli RA; Uniformed Services University of the Health Sciences, Bethesda, Maryland., Woodcock M; Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom., Kuhn F; Helen Keller Foundation for Research and Education, Birmingham, Alabama., Watson SL; The University of Sydney, Save Sight Institute, Faculty of Medicine and Health, Sydney, NSW, Australia., Gomes RSM; BRAVO VICTOR, Research & Innovation, London, United Kingdom; Northern Hub for Veterans and Military Families Research, Northumbria University, Newcastle, United Kingdom., Agrawal R; National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore; Singapore Eye Research Institute, Singapore; Lee Kong Chian School of Medicine, Singapore; Duke NUS Medical School, Singapore., Blanch RJ; Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Neuroscience & Ophthalmology, Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom; Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, United Kingdom. Electronic address: blanchrj@bham.ac.uk.
Jazyk:	angličtina
Zdroj:	Ophthalmology. Retina [Ophthalmol Retina] 2023 Nov; Vol. 7 (11), pp. 972-981. Date of Electronic Publication: 2023 Jul 04.
DOI:	10.1016/j.oret.2023.06.022
Abstrakt:	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. (Copyright © 2023 American Academy of Ophthalmology. All rights reserved.)
Databáze:	MEDLINE
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