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MP Blair, J Pearlman, JB Harlan, M Siler; Intravenous Versus Intravenous Antibiotics for the Prophylaxis of Postraumatic Endophthalmitis . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4446.
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Purpose: To determine whether the choice of antibiotic prophylaxis of post-traumatic endophthalmitis by either intravitreal or intravenous administration affects length of hospital stay, cost of therapy, visual outcome, or rate of development of endophthalmitis. Methods: After obtaining Institutional Review Board approval, a retrospective chart review study was performed to evaluate the effect of administration route on outcomes, including visual acuity at last visit, change in visual acuity from presentation, development of endophthalmitis, length of hospital stay, and cost of treatment. Injuries were stratified according to type, grade, pupil status, and zone, following Pieramici et al (American Journal of Ophthalmology 123:820-831, 1997). Results: Ninety-four patients were treated with intravenous antibiotics, while 28 were treated with intravitreal antibiotics. Preliminary results indicate that with intravitreal antibiotics the mean length of stay decreased from 2.7 days to 2.15 days. Median total charges decreased from $4,926 to $4,561 with intravitreal antibiotics. However, neither of these differences was statistically significant. Preliminary data on visual outcome and development of endophthalmitis also show no statistical difference between routes of administration. Conclusion: Intravitreal administration of antibiotics achieves similar visual outcomes to intravenous administration in the prophylaxis of post-traumatic endophthalmitis. This method of administration also may decrease length of hospital stay and costs, although this was not demonstrated with statistical significance in this relatively small retrospective study.
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