OBJECTIVE Not all strabismus surgeons use prophylactic topical antibiotics postoperatively because they may be poorly tolerated, costly, and may increase antimicrobial resistance. The purpose of the study is to assess the effect of postoperative topical antibiotics on the rate of surgical site infections following strabismus surgery. DESIGN Retrospective clinical cohort study. PARTICIPANTS Patients who underwent strabismus surgery in the past 20 years. Patients who were or were not prescribed postoperative topical antibiotics comprised the study and control groups, respectively. METHODS This study was conducted using data from TriNetX, an international electronic health-record registry containing data for over 130 million patients. Strabismus surgery patients were identified using CPT codes. The prescription of eye topical antibiotics and the frequency of surgical site infections were identified by RxNorm and ICD-10 codes, respectively. Analysis was conducted using the measures of association feature of TriNetX. Patient demographics such as age, sex, and race were recorded based on their presence in the electronic records system. MAIN OUTCOME MEASURE Development of endophthalmitis, orbital and preseptal cellulitis. RESULTS There were 84,052 patients who underwent strabismus surgery. 38,484 (46%) patients received one or more postoperative topical antibiotics. About 70% of the patients were White and 10% Black. There was a slight female preponderance (51%). Endophthalmitis developed in 16 patients (0.019%), orbital cellulitis in 24 patients (0.029%) and preseptal cellulitis in 55 patients (0.065%). There was no difference in the rates of endophthalmitis, orbital, and preseptal cellulitis between the groups (p values 0.855, 0.684, 0.925 respectively). CONCLUSIONS The prescription of prophylactic topical antibiotics did not decrease rates of surgical site infections following strabismus surgery. Administering postoperative topical antibiotics can be distressing to children, costly, and may contribute to antimicrobial resistance. Given no clear advantage and potential disadvantages, the use of postoperative topical antibiotics following strabismus surgery may not be beneficial.

中文翻译：

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预防性局部抗生素对斜视手术后感染并发症发生率的影响：一项大型数据库研究。


目的 并非所有斜视外科医生在术后预防性局部使用抗生素，因为它们的耐受性可能差、成本高昂，并且可能会增加抗菌素耐药性。该研究的目的是评估术后局部抗生素对斜视手术后手术部位感染率的影响。设计 回顾性临床队列研究。参与者 在过去 20 年中接受过斜视手术的患者。术后局部抗生素处方或未处方抗生素的患者分别属于研究组和对照组。方法 本研究使用来自 TriNetX 的数据进行，TriNetX 是一个国际电子健康记录登记处，包含超过 1.3 亿患者的数据。斜视手术患者使用 CPT 代码识别。眼部局部抗生素处方和手术部位感染频率分别通过 RxNorm 和 ICD-10 代码确定。使用 TriNetX 的关联特征测量进行分析。根据患者在电子记录系统中的存在情况记录患者人口统计数据，例如年龄、性别和种族。主要结局指标 眼内炎、眼眶和眶隔前蜂窝织炎的发展。结果 有 84,052 例患者接受了斜视手术。38,484 例 （46%） 患者接受了一种或多种术后局部抗生素治疗。大约 70% 的患者是白人，10% 是黑人。女性略占优势 （51%）。16 例患者 （0.019%） 发生眼内炎，24 例患者发生眼眶蜂窝织炎 （0.029%），55 例患者发生眶隔前蜂窝织炎 （0.065%）。两组之间眼内炎、眼眶和眨隔前蜂窝织炎的发生率无差异 （p 值分别为 0.855 、 0.684 、 0.925）。 结论 预防性局部抗生素处方并未降低斜视手术后手术部位感染的发生率。术后局部抗生素给药可能会让儿童感到痛苦，成本高昂，并可能导致抗菌素耐药性。鉴于没有明显的优点和潜在的缺点，斜视手术后使用术后局部抗生素可能没有益处。