6533b7d4fe1ef96bd12634de
RESEARCH PRODUCT
POOLED ESTIMATES OF INCIDENCE OF ENDOPHTHALMITIS AFTER INTRAVITREAL INJECTION OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR AGENTS WITH AND WITHOUT TOPICAL ANTIBIOTIC PROPHYLAXIS
Alfredo PulvirentiCesare MariottiClaudio BucoloTeresio AvitabileAndrea RussoAntonio LongoMichele ReibaldiGuglielmo ParisiRodolfo MastropasquaVincenza Bonfigliosubject
Vascular Endothelial Growth Factor Amedicine.medical_specialtyEye InfectionsVisual AcuityAntibiotic prophylaxis; Anti–vascular endothelial growth factor; Endophthalmitis; Intravitreal injection;Angiogenesis InhibitorsCochrane LibraryGlobal HealthEye Infections Bacteriallaw.invention03 medical and health sciencestopical antibiotic prophylaxis; postoperative endophthalmitis; anti–vascular endothelial growth factor agents; intravitreal injectionpostoperative endophthalmitis0302 clinical medicineEndophthalmitisRandomized controlled triallawtopical antibiotic prophylaxisanti–vascular endothelial growth factor agentsInternal medicinemedicineantibiotic prophylaxiHumansanti-vascular endothelial growth factor030212 general & internal medicineAntibiotic prophylaxisProspective cohort studyAntibiotic prophylaxis; Anti–vascular endothelial growth factor; Endophthalmitis; Intravitreal injection; Angiogenesis Inhibitors; Anti-Bacterial Agents; Endophthalmitis; Eye Infections Bacterial; Global Health; Humans; Intravitreal Injections; Vascular Endothelial Growth Factor A; Antibiotic Prophylaxis; Visual AcuityEndophthalmitisbusiness.industryIncidence (epidemiology)Bacterialintravitreal injectionRetrospective cohort studyGeneral MedicineEye infectionAntibiotic Prophylaxismedicine.diseaseAntibiotic prophylaxis; Anti–vascular endothelial growth factor; Endophthalmitis; Intravitreal injection; Angiogenesis Inhibitors; Anti-Bacterial Agents; Endophthalmitis; Eye Infections; Bacterial; Global Health; Humans; Intravitreal Injections; Vascular Endothelial Growth Factor A; Antibiotic Prophylaxis; Visual AcuitySurgeryAnti-Bacterial AgentsOphthalmologyendophthalmitiIntravitreal Injections030221 ophthalmology & optometryAnti–vascular endothelial growth factorbusinessdescription
Purpose: To assess the effect of topical antibiotic prophylaxis on postoperative endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents.Methods: A systematic literature search was performed from inception to March 2016 using PubMed, Medline, Web of Science, Embase, and the Cochrane Library, to identify articles that reported cases of endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents. We used a pooled analysis to estimate the incidence of cases of endophthalmitis who developed after injections performed with and without topical antibiotic prophylaxis. We used regression analysis to explore the effects of study characteristics on heterogeneity.Results: From our search of electronic databases, we identified and screened 4,561 unique records. We judged 60 articles to have reported findings for cohorts of patients who met our inclusion criteria, (12 arms of randomized clinical trials, 11 prospective cohort studies, and 37 retrospective cohort studies), which included 244 cases of endophthalmitis and 639,391 intravitreal injections of anti-vascular endothelial growth factor agents. The final pooled estimate endophthalmitis proportions were 9/10,000 (95% confidence interval, 7/10,000-12/10,000) in the antibiotic-treated group and 3/10,000 (95% confidence interval, 2/10,000-5/10,000) in the untreated group. The estimated incidence of endophthalmitis with topical antibiotic prophylaxis was approximated three times the incidence without prophylaxis. Random effects regression showed that none of the study characteristics significantly affected the effect size in either group.Conclusion: Topical antibiotic after intravitreal injection of anti-vascular endothelial growth factor agents is associated with a higher risk of endophthalmitis.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2017-03-08 |