Post-traumatic endophthalmitis prophylaxis: a systematic review and meta-analysis

Joshua M Van Swol; Walter K Myers; Jonathan A Beall; Miriam M Atteya; Jeffrey P Blice

doi:10.1186/s12348-022-00317-y

Post-traumatic endophthalmitis prophylaxis: a systematic review and meta-analysis

J Ophthalmic Inflamm Infect. 2022 Nov 18;12(1):39. doi: 10.1186/s12348-022-00317-y.

Authors

Joshua M Van Swol¹, Walter K Myers², Jonathan A Beall³, Miriam M Atteya², Jeffrey P Blice⁴

Affiliations

¹ College of Medicine, Medical University of South Carolina, Charleston, SC, USA. jmv201@musc.edu.
² College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
³ Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
⁴ Department of Ophthalmology-Vitreoretinal Surgery, Medical University of South Carolina, Charleston, SC, USA.

Abstract

Purpose: The goal of this study is to determine if certain aspects of endophthalmitis prophylaxis strategies are superior to others.

Design: This investigation is a systematic review and meta-analysis.

Methods: All studies specifying a type of prophylaxis strategy and resulting rates of endophthalmitis were included. Time course, method of administration, and antibiotic regimen, and confounding factors were collected and included for meta-regression.

Results: Time courses greater than 24 h did not significantly improve outcomes. Likewise, intraocular and/or intravenous antibiotic administration methods did not significantly outperform oral administration. No antibiotic regimens performed differently from vancomycin/ ≥ 3^rd generation cephalosporin except for ciprofloxacin monotherapy which yielded significantly worse outcomes.

Conclusions: Future antibiotic strategies should strongly consider the risks of antibiotic treatment > 24 h and administration methods other than the oral antibiotic forms. In addition, providers should be wary of using ciprofloxacin monotherapy for endophthalmitis prophylaxis when treating open globe injuries.

Keywords: Endophthalmitis; Meta-analysis; Open globe; Post-traumatic; Prophylaxis; Systematic review.