August 06, 2013
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Combination therapy may be most effective treatment for suspected bacterial endophthalmitis

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Combination therapy is recommended in treatment of suspected bacterial endophthalmitis to target both gram-positive and gram-negative organisms, according to a 10-year review.

The retrospective, noncomparative, consecutive case series included cases with culture-proven endophthalmitis from the Bascom Palmer Eye Institute between 2002 and 2011. The series measured antibiotic susceptibilities and all intravitreal isolates identified.

Of the 448 organisms identified, the most common were Staphylococcus epidermidis (30.1%), Streptococcus viridians (10.9%), Staphylococcus aureus (7.8%) and Candida albicans (5.8%).

Among the 448 isolates, 327 (72.9%) were gram-positive organisms, 48 (10.7%) were gram-negative organisms, 71 (15.8%) were fungi and two (0.4%) were viruses. All gram-negative organisms were susceptible to ceftazidime and levofloxacin, and all gram-positive were susceptible to vancomycin.

No single antibiotic provided coverage for all of the microbes isolated from eyes with endophthalmitis, the authors said.

Disclosure: The study authors report no relevant financial disclosures.

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