Intracameral antibiotic prophylaxis and surgical expertise: key determinants in endophthalmitis after cataract surgery
Abstract
Postoperative endophthalmitis is a rare but severe complication of cataract surgery. Intracameral moxifloxacin prophylaxis has been widely adopted, but concerns remain regarding bacterial resistance and clinical outcomes. This study aimed to evaluate the impact of intracameral moxifloxacin prophylaxis on endophthalmitis incidence, microbiological patterns, antibiotic resistance, and visual outcomes in a university hospital setting, with comparison to a private hospital cohort. This retrospective cohort study analyzed 21,178 cataract surgeries performed at a university hospital (2014–2023). The incidence of endophthalmitis, microbiological profiles, resistance patterns, and visual acuity outcomes (LogMAR) were assessed. Intracameral moxifloxacin prophylaxis was introduced in 2019. A comparative analysis was conducted with 19,360 surgeries from a private hospital. Fisher’s exact test, Mann-Whitney U test, and Joinpoint regression were used for statistical analysis. Endophthalmitis incidence at the university hospital was 0.109% (23/21,178 surgeries), significantly higher than the 0.021% incidence in the private hospital (p = 0.002). Post-prophylaxis, infection rates declined from 0.219% in 2016 to 0.042% in 2023 (p = 0.003). Staphylococcus epidermidis predominated (52.6%), and moxifloxacin resistance remained stable (pre: 45.5%; post: no increase). Intracameral moxifloxacin significantly reduced endophthalmitis incidence without increasing bacterial resistance.…
How strong is the evidence?
Evidence Hub reads this as a cohort study. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
Read the paper
Related studies
- Synthesis, In Vitro and In Silico Molecular Docking Studies of Novel Phthalimide–Pyrimidine Hybrid Analogues to Thalidomide as Potent Antitubercular Agents
- Exploring the inhibitory performance of expired moxifloxacin and norfloxacin on copper corrosion in saline environment
- Molecular investigation of antimicrobial peptides against Helicobacter pylori proteins using a peptide-protein docking approach
- Screening of novel narrow-spectrum benzofuroxan derivatives for the treatment of multidrug-resistant tuberculosis through in silico, in vitro, and in vivo approaches
- Synthesis, Characterization, Anticancer, Antioxidant, and In Silico Evaluation of Semicarbazides and Thiosemicarbazides
- Fast and accurate prediction of drug induced proarrhythmic risk with sex specific cardiac emulators
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.