Graefe's Archive for Clinical and Experimental Ophthalmology ( IF 2.4 ) Pub Date : 2023-05-25 , DOI: 10.1007/s00417-023-06112-2 Kenneth J Taubenslag 1 , Edward F Cherney 1 , Shriji N Patel 1 , Janice C Law 1 , Anthony B Daniels 1 , Stephen J Kim 1, 2
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Purpose
Increasing rates of antibiotic resistance in endophthalmitis have been reported. This study examines outcomes of triple therapy with intravitreal vancomycin, ceftazidime, and moxifloxacin for endophthalmitis.
Methods
Retrospective, consecutive series of all patients treated with abovementioned intravitreal antibiotics from January 2009 to June 2021. Percentages of eyes attaining greater than or equal to 20/200 and 20/50 Snellen visual acuities and adverse events were evaluated.
Results
112 eyes met inclusion criteria. 63 of 112 eyes (56%) achieved a visual acuity of 20/200 during follow-up, with 39 (35%) returning to at least 20/50. In subgroup analysis, 23 of 24 (96%) eyes with post-cataract endophthalmitis obtained ≥ 20/200 acuity and 21 of 24 (88%) obtained ≥ 20/50 acuity during follow-up. There were no cases of macular infarction.
Conclusions
Intravitreal moxifloxacin (160 µg/0.1 mL) was well tolerated as an adjunct to vancomycin and ceftazidime for bacterial endophthalmitis. Use of this novel combination offers several theoretical advantages compared to standard therapy with two antibiotics, including expanded gram-negative coverage and potential synergy, and may be particularly valuable in geographies where the local antibiogram supports empiric use. Further study is merited to verify the safety and efficacy profile.
中文翻译：
万古霉素、头孢他啶和莫西沙星玻璃体内三联疗法治疗细菌性眼内炎：十二年经验
目的
据报道，眼内炎的抗生素耐药率不断增加。本研究探讨了玻璃体内注射万古霉素、头孢他啶和莫西沙星三联疗法治疗眼内炎的结果。
方法
对 2009 年 1 月至 2021 年 6 月期间接受上述玻璃体内抗生素治疗的所有患者进行回顾性、连续系列研究。评估了达到大于或等于 20/200 和 20/50 Snellen 视力的眼睛百分比和不良事件。
结果
112 只眼睛符合纳入标准。112 只眼睛中的 63 只 (56%) 在随访期间达到了 20/200 的视力，其中 39 只 (35%) 恢复到至少 20/50。在亚组分析中，24 只患有白内障后眼内炎的眼睛中的 23 只 (96%) 获得了 ≥ 20/200 的视力，24 只眼睛中的 21 只 (88%) 在随访期间获得了 ≥ 20/50 的视力。无黄斑梗塞病例。
结论
玻璃体内注射莫西沙星（160 µg/0.1 mL）作为万古霉素和头孢他啶的辅助药物治疗细菌性眼内炎具有良好的耐受性。与两种抗生素的标准疗法相比，使用这种新型组合具有多种理论上的优势，包括扩大革兰氏阴性菌覆盖范围和潜在的协同作用，并且在当地抗菌谱支持经验性使用的地区可能特别有价值。值得进一步研究来验证安全性和有效性。
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