Effect of a topical antibiotic and povidone-iodine vs povidone-iodine alone on conjunctival flora:systematic review and meta-analysis
Abstract
Combining topical antibiotics with PVI, excluding levofloxacin, does not significantly reduce conjunctival bacterial contamination compared with PVI alone, providing essential insight into the optimal preoperative antiseptic method for ophthalmic procedures. Topic: This systematic review and meta-analysis aimed to determine whether adding preoperative topical antibiotics to povidone–iodine (PVI) offers any additional benefit over PVI alone in reducing conjunctival bacterial flora, thereby potentially lowering the risk of postoperative endophthalmitis. The participants included 1423 eyes undergoing elective intraocular surgeries (eg, cataract, keratoplasty, and trabeculectomy) or receiving intravitreal injections. The interventions studied were PVI combined with third-generation quinolones (levofloxacin, moxifloxacin, or gatifloxacin) compared with PVI alone. The outcome measure was postintervention rate of positive conjunctival bacterial cultures before ophthalmic procedure. Clinical Relevance: Postoperative endophthalmitis is a rare but serious complication of intraocular surgery, potentially leading to significant vision loss. Although PVI is widely recognized as an essential prophylactic measure, the role of preoperative topical antibiotics remains debated. Defining the necessity of antibiotic use in routine cataract surgery is important, especially given the concerns about antibiotic resistance and the rising cost of health care. The current standard of care varies…
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