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Jason Mingyi Huang, Preston H Blomquist; Use of intravenous vancomycin and cefepime in preventing endophthalmitis after open globe injury. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6045.
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Prior studies have investigated the use of intravenous vancomycin and ceftazidime for preventing endophthalmitis after post-traumatic open globe injuries. However, no studies have examined the use of vancomycin and cefepime for this purpose. We performed a retrospective cohort study to determine the rate of endophthalmitis after open globe injury with administration of vancomycin and cefepime.
Charts of all patients (173 in total) who presented to Parkland Health and Hospital System for open globe injury between June 1, 2009 and June 16, 2013 were reviewed. Data collection included time from injury to initial presentation, mechanism of injury, ophthalmological exam details, timing of globe repair, and length of follow-up. All patients were treated with a standardized protocol of vancomycin and cefepime for 48 hours. Open globe surgical repairs were performed by University of Texas Southwestern Department of Ophthalmology faculty members. The primary outcome measure was rate of endophthalmitis, and the secondary outcome measure was risk factors for developing endophthalmitis.
Out of 173 patients who presented after open globe injury, 3 patients had signs of endophthalmitis on initial exam prior to starting antibiotics, and 2 patients developed endophthalmitis after initiation of Vancomycin and Cefepime (1.2%). Delayed time from injury to presentation was a risk factor for post-traumatic endophthalmitis (P=0.0001). Association between presence of intraocular foreign body and post-traumatic endophthalmitis was approaching significance (P=0.057).
Use of intravenous vancomycin and cefepime for prophylaxis against endophthalmitis after open globe injury resulted in an endophthalmitis rate of 1.2%.
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