Management of Endophthalmitis with and without Topical Antibiotics: A Case-Control Study

Abstract

<b><i>Purpose:</i></b> The aim of this study was to compare the management outcome of endophthalmitis with and without the use of topical antibiotics. <b><i>Methods:</i></b> A retrospective comparative chart review of 2 cohorts of endophthalmitis (other than those associated with open-globe injury, keratitis, or wound site infection), one managed with topical antibiotics (TA group) and one without (NTA group), was performed. <b><i>Results:</i></b> The study included a total of 270 eyes of 270 patients. Of these, 169 eyes were in the TA group and 101 were in the NTA group. Post-cataract surgery was the most common etiology, accounting for 81.06 and 78.2% of cases, respectively (<i>p</i> = 0.57). A favorable functional outcome at the last visit was seen in 37.5 and 39.6% of eyes (<i>p</i> = 0.73), and a favorable anatomic outcome was noted in 61.2 and 49.5% of eyes (<i>p</i> = 0.06), respectively. The median follow-up was 3.5 and 9 months, respectively (<i>p</i> &#x3c; 0.0001). Susceptibilities to the common antibiotics used (vancomycin, ceftazidime, and amikacin) were comparable, with the exception of imipenem, for which the susceptibility noted was 95 and 66%, respectively (<i>p</i> = 0.01). Culture positivity in the TA group was seen in 72 out of 169 eyes (42.6%), while in the NTA group it was seen in 98 out of 101 eyes (97.02%; <i>p</i> &#x3c; 0.0001). <b><i>Conclusion:</i></b> Topical antibiotics do not give any added advantage in the management of endophthalmitis otherwise being treated with intravitreal antibiotics and standard vitrectomy techniques.