July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Antibiotic prophylaxis and intravitreal injections: impact on the incidence of acute endophthalmitis
Author Affiliations & Notes
  • Florian BAUDIN
    Ophthalmology, Dijon University Hospital, Dijon, Côte d'Or, France
    Physiology and cerebral and ischemic cardio-vascular diseases, Burgundy University, Dijon, France
  • Eric Benzenine
    Biostatistics and Bioinformatics (DIM), Dijon University Hospital, Dijon, France
  • Anne-Sophie Mariet
    Biostatistics and Bioinformatics (DIM), Dijon University Hospital, Dijon, France
    Dijon University, Dijon, France
  • Alain M Bron
    Ophthalmology, Dijon University Hospital, Dijon, Côte d'Or, France
    Eye and Nutrition Research Group, Bourgogne Franche-Comté University, Dijon, France
  • Vincent Daien
    Ophthalmology, Montpellier University Hospital, Montpellier, France
    U1061, INSERM, Montpellier, France
  • Jean-Francois Korobelnik
    Ophthalmology, Bordeaux University Hospital, Bordeaux, France
    U1219, INSERM, Bordeaux, Falkland Islands [Malvinas]
  • Catherine Quantin
    Biostatistics and Bioinformatics (DIM), Dijon University Hospital, Dijon, France
    Dijon University, Dijon, France
  • Catherine Creuzot-Garcher
    Ophthalmology, Dijon University Hospital, Dijon, Côte d'Or, France
    Eye and Nutrition Research Group, Bourgogne Franche-Comté University, Dijon, France
  • Footnotes
    Commercial Relationships   Florian BAUDIN, None; Eric Benzenine, None; Anne-Sophie Mariet, None; Alain Bron, None; Vincent Daien, None; Jean-Francois Korobelnik, None; Catherine Quantin, None; Catherine Creuzot-Garcher, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2026. doi:https://doi.org/
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      Florian BAUDIN, Eric Benzenine, Anne-Sophie Mariet, Alain M Bron, Vincent Daien, Jean-Francois Korobelnik, Catherine Quantin, Catherine Creuzot-Garcher; Antibiotic prophylaxis and intravitreal injections: impact on the incidence of acute endophthalmitis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2026. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To study the role of antibiotic prophylaxis in reducing the risk of acute endophthalmitis after intravitreal injections, in France, between 1 January 2012 and 31 December 2015.

Methods : The French national inter-scheme health insurance information system was used to estimate the incidence rate of acute endophthalmitis after intravitreal injection (IVT) at a national scale and its risk factors. The occurrence of acute endophthalmitis was sought within 42 days after the IVT. Its association with age, sex, diabetes, injected product, and topical antibiotic prophylaxis was analyzed by multivariate Poisson regression.

Results : A total of 1,811,977 intravitreal injections were performed on 254,927 patients. The proportion of IVT with antibiotic prophylaxis for anti-VEGF and corticosteroids from 2013 to 2015, dropped from 82.7% to 59.1% and 84.8% to 64.2%, respectively. Acute endophthalmitis occurred in 444 cases (incidence rate = 0.0245%). The number of endophthalmitis in the absence of antibiotic prophylaxis was 114 for anti-VEGF and 14 for corticosteroids IVTs. The time to onset of endophthalmitis did not differ according to the status of antibiotic prophylaxis. Univariate analysis on repeated data did not find any difference in risk depending on the status of antibiotic prophylaxis or therapeutic classes but showed an increased risk of endophthalmitis for antibiotics associated with corticosteroids compared to antibiotics alone (IRR 1.67; 95% CI 1.08-2.57; P= .02). This finding did not remain significant in multivariate analyses.

Conclusions : These results are consistent with the literature. Endophthalmitis rates with or without antibiotic prophylaxis are similar. Avoiding antibiotic prophylaxis would reduce the costs as well as the risks of antibiotic resistance.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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