Trend and Challenges of Antimicrobial Susceptibility of Bacteria and Fungi Causing Endophthalmitis: A Microbiological Perspective on Global Trends

Autor: Bhavani Sontam, Savitri Sharma, Joveeta Joseph
Rok vydání: 2017
Předmět:
Zdroj: Endophthalmitis ISBN: 9789811052590
DOI: 10.1007/978-981-10-5260-6_27
Popis: Prevention and elimination of endophthalmitis are a constant goal of every ophthalmic surgeon. Today virtually every surgeon follows a standard of care that involves antisepsis and antibiotics without knowing exactly the reason (why), the modality (how), and the precise time (when) to intervene with effective prophylactic measures [1]. The introduction of various antimicrobials for treating a variety of infections was the reason for performing antimicrobial susceptibility testing as a routine procedure in all microbiology laboratories. Pharmacokinetics and spectrum of activity of antimicrobial intravitreal drugs are an important consideration. Dose, pH, ionization, protein binding, and route of entry also affect the drug concentration. Ocular factors such as the surgical status of the eye, the presence or absence of lens and vitreous, and degree of breakdown of the blood retinal barrier are the host factors to consider [2]. The microbial spectra and susceptibility patterns have exhibited variations over time and differ according to geographic location, population, and ethnic groups. Because of the rapidly progressive nature of endophthalmitis, it is important to monitor the microbial spectra and antibiotic susceptibilities at the local level through periodic analyses to ensure that empirical therapy remains appropriate [1]. The results of in vitro antibiotic susceptibility testing guide clinicians in an appropriate selection of initial empiric regimens and the drugs used for individual patients in specific situations. The selection of an antibiotic panel for susceptibility testing is based on the commonly observed susceptibility patterns and is revised periodically. In the present chapter, we have reviewed the global trends in the last few decades in the changes in antibiotic susceptibility patterns for bacteria and fungi causing endophthalmitis.
Databáze: OpenAIRE