Abstract
Purpose: :
To assess the most common antibiotic regimens for endophthalmitis prophylaxis and demographics of hospital stay after open globe repair.
Methods: :
Retrospective chart review of 278 patients with primary open globe repairs performed at the University Hospital, NJMS, Newark between 2005 and 2009. Age, prophylactic antibiotic use, duration of post-operative inpatient stay, presenting endophthalmitis status, comorbidities that lead to prolonged inpatient stay, intraocular foreign body (IOFB) status, time from injury to surgery (48hrs), and zone of injury were recorded for each patient. The average inpatient stay was stratified with respect to the following factors: endophthalmitis at presentation, comorbidities, IOFB status, time from injury to surgery, zone of injury, and age. Most common inpatient and outpatient antibiotics were analyzed based on age and presence of IOFB.
Results: :
There were 278 patients. Mean age was 38.6 years. Average duration of post-operative stay was 3.97 days and follow-up was 10.5 months. The length of inpatient stay among patients with comorbidities was significantly longer than for those without comorbidites (p-value<0.0001). Even excluding patients who stayed >20 days due to non-ocular problems, zone 3 injuries significantly prolonged inpatient stay (p-value<0.0001). Most common inpatient intravenous (IV) antibiotic across all subgroups was a combination of vancomycin and ceftazidime. Most adults and children ≥12 years were discharged on oral Levaquin while most children <12 years were discharged on oral Augmentin. Quixin was the most commonly prescribed topical antibiotic that patients were discharged with across all subgroups except patients with IOFB.
Conclusions: :
Comorbidities, especially acute or chronic medical problems and social issues, prolonged patients’ hospital stays. Patients with zone 3 injuries had significantly longer inpatient stays than zone 1 and 2 injuries. Time from open globe injury to surgery, IOFB status, and use of pars plana vitrectomy for IOFB patients did not significantly prolong stay. Hospital stays among different age groups were similar.
Keywords: trauma • antibiotics/antifungals/antiparasitics