Abstract
Abstract: :
Purpose:To compare endophthalmitis rates associated with the use of topical ofloxacin vs. ciprofloxacin post phacoemulsification. Methods:An endophthalmitis reporting database was developed to report post-operative endophthalmitis cases involving phacoemulsification at the John A. Moran Eye Center from January, 1997 to March, 2001. Endophthalmitis cases were reported to hospital epidemiology when clinically diagnosed. Investigators were not given access to case specific information and were masked throughout the four year period. Phacoemulsification procedures were standardized during the time period with exception to a possible corneal shield application. After four years, retrospective analysis of endophthalmitis rates, demographic analysis review of possible co-morbidity factors and postoperative antibiotic use were all reviewed. Finally, comparative analysis of endophthalmitis rate vs. antibiotic prescribed was performed. Results:A total of 9,079 patients underwent phacoemulsification surgery. There were a total of 24 cases of clinically diagnosed endophthalmitis reported. Among the 9,079 patients, prescription volumes for ciprofloxacin and ofloxacin were nearly identical. A total of 4,615 patients received ciprofloxacin (50.8%)and 4,464 patients received ofloxacin (49.2%). Among reported endophthalmitis cases, 11 patients received collagen shields soaked with antibiotic and steroid, 13 did not. Of the 24 endophthalmitis cases, 20 patients (83.3%) received ciprofloxacin as their post-operative antibiotic and 4 patients (16.7%) received ofloxacin as their post-operative antibiotic. The difference in rates of reported infection were signficant, with a p value of <0.0009. Conclusion:Of 24 cases of endophthalmitis, patients receiving topical ofloxacin postoperatively developed endophthalmitis significantly less than those receiving topical ciprofloxacin (P<0.0009). The differences in endophthalmitis rates may reflect differences in pharmacological and bioavailability properties that exist among quinolone antibiotics.
Keywords: 398 endophthalmitis • 319 antibiotics/antifungals/antiparasitics • 514 pharmacology