12th Vitreoretinal Symposium Frankfurt – Marburg 2009

Scientific programm: Abstract

2nd scientific session: (Core) PPV

7. Perioperative Treatment with Antibiotics

Anna Sophia Bauch (Frankfurt/Main)

Purpose: To show the efficacy of topic azithromycin as a preoperative prophylaxis against endophthalmitis.
Methods: Evaluation of 30 patients with chronic blepharitis undergoing intravitreal injections of bevacizumab and dexamethasone/triamcinolone with/out core-vitrectomy for the treatment of macular edema due to diabetic retinopathy or retinal vein occlusion. Antibiotic prophylaxis was applied exclusively before surgery and started two days preoperative with two drops of 1.5% azithromycin (Azyter®, Thea Pharma) on each day; drop number five was given directly before the intervention and the last drop directly at the end of it. Conjunctival swabs were taken before the topical application and afterwards before the instillation of povidone iodide in the operating theatre. Bacterial growth was evaluated, and resistance to standard antibiotics was tested. Postoperative there was no need to apply antibiotic eye drops.
Results: In 24 out of 30 eyes bacterial growth in the swabs before application of topical antibiotics was detected. All bacteria species were attendant to the skin flora: Staphylococcus epidermidis, Staphylococcus aureus, Enterobacteriaceae. The swabs of 30 out of 30 eyes showed no bacterial growth directly preoperative.
Conclusion: Azithromycin eyedrops are effective in the elimination of conjunctival bacterial flora before operative interventions. The easy and short preoperative procedure promotes patient’s compliance. No postoperative treatment is needed in these limited procedures. This concept might support the reduction of the incidence of postoperative endophthalmitis.