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A. Zavala Ayala, R. Velez-Montoya, H. Quiroz-Mercado, V. Vanzinni-Zago, A. Ortiz-González, V. Morales-Cantón; Intravitreal Moxifloxacin for the Treatment of Vancomycin/Ceftazidime-Resistant Endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6034.
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To describe the anatomical and functional changes in two cases of vancomycin/ceftazidime-resistant endophthalmitis treated with intravitreal Moxifloxacin.
Retrospective study. The clinical records of all patients with diagnosis of endophthalmitis in which the isolated microorganisms were resistant to vancomycin and ceftazidime, and that were treated with 0.5% intravitreal moxifloxacin since January 2008 to date were reviewed. Both eyes were treated with intravitreal vancomycin and ceftazidime at the time of diagnosis, and treatment with moxifloxacin was administered after culture and resistance results were available. The anatomical and functional outcome as well as the outcome of the infection in each case is described.
Two eyes of two patients met the inclusion criteria. The first patient was an endophthalmitis secondary to corneal perforation due to Sjögren syndrome and the second due to drainage implant blebitis. The isolated microorganisms in the first patient were Enterococcus faecalis and Enterobacter cloacae. In the second case the isolated microorganism organism was Serratia marcescens. Both patients were treated with 0.1ml of 0.5% intravitreal moxifloxacine and 0.1 ml of dexamethasone. Only in the second case the infection succeeded after intravitreal treatment. In the first case the infection progressed and a pars plana vitrectomy was required. After 2 month follow-up both patients had an attached retina and best corrected visual acuity of light perception and color discrimination.
In cases of Vancomycin-resistant endophthalmitis, the use of intravitreal moxifloxacine is a feasible option with acceptable outcomes. More studies are needed to exclude retinal toxicity.
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