Are Prophylactic Systemic Antibiotics Required in Patients with Cataract Surgery at Local Anesthesia?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Preoperative Conjunctival Sac Culture
2.3. Surgical Procedure
3. Results
3.1. The Use of Systemic Antibiotics in Five Stages
3.2. Preoperative Conjunctival Sac Culture
3.3. Incidence of Postoperative Infection
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Stage | Period | Intravenous Antibiotics on Surgery Day | Oral Antibiotics on Surgery Day | Oral Antibiotics on the Next 2 Days | Number of Surgery | Right Eye/Left Eye | Men/ Women | Range of Age (Median) |
---|---|---|---|---|---|---|---|---|
Stage 1 | April 2016–18 January 2018 | Cefazolin 1 g | Cefdinir 100 mg | Cefdinir 300 mg | 649 | 333/316 | 194/229 | 41–93 (77) |
Stage 2 | 26 January 2018–August 2019 | None | Cefdinir 200 mg | Cefdinir 300 mg | 541 | 273/268 | 158/187 | 50–101 (77) |
Stage 3 | September 2019–December 2019 | None | Levofloxacin 500 mg | Levofloxacin 500 mg | 103 | 54/49 | 25/47 | 56–92 (76) |
Stage 4 | January 2020–October 2021 | None | Levofloxacin 500 mg | None | 545 | 270/275 | 144/202 | 45–94 (77) |
Stage 5 | November 2021–October 2022 | None | None | None | 311 | 160/151 | 84/111 | 47–101 (75) |
Stage | Stage 1 | Stage 2 | Stage 3 | Stage 4 | Stage 5 | |||||
---|---|---|---|---|---|---|---|---|---|---|
Period | April 2016–18 January 2018 | 26 January 2018–August 2019 | September 2019–December 2019 | January 2020–October 2021 | November 2021–October 2022 | |||||
Right eye (R.E.) or left eye (L.E.) | R.E. | L.E. | R.E. | L.E. | R.E. | L.E. | R.E. | L.E. | R.E. | L.E. |
The number of surgeries | 333 | 316 | 273 | 268 | 54 | 49 | 270 | 275 | 160 | 151 |
The number of negative culture | 255 | 238 | 186 | 182 | 42 | 37 | 238 | 242 | 123 | 130 |
The percent of negative culture | 77% | 75% | 68% | 68% | 78% | 76% | 88% | 88% | 77% | 86% |
The number of positive culture | 78 | 78 | 87 | 86 | 12 | 12 | 32 | 33 | 37 | 21 |
The percent of positive culture | 23% | 25% | 32% | 32% | 22% | 24% | 12% | 12% | 23% | 14% |
Positive bacterial species | ||||||||||
Coagulase-negative staphylococcus (MR-CNS) | 27 | 21 | 35 | 25 | 5 | 7 | 10 | 20 | 2 | 5 |
Staphylococcus aureus (MRSA) | 2 | 3 | 2 | 3 | 1 | 0 | 5 | 1 | 0 | 1 |
MR-CNS and MRSA in total | 29 | 24 | 37 | 28 | 6 | 7 | 15 | 21 | 2 | 6 |
The percent of MR-CNS and MRSA in positive culture | 37% | 31% | 43% | 33% | 50% | 58% | 47% | 64% | 5% | 29% |
Coagulase-negative staphylococcus (MS-CNS) | 47 | 49 | 45 | 46 | 11 | 11 | 23 | 17 | 8 | 3 |
Staphylococcus epidermidis | 0 | 0 | 0 | 0 | 0 | 0 | 7 | 5 | 29 | 18 |
Staphylococcus aureus (MSSA) | 6 | 13 | 12 | 8 | 1 | 1 | 12 | 14 | 4 | 5 |
α streptococci | 8 | 4 | 13 | 5 | 0 | 2 | 4 | 6 | 1 | 1 |
β streptococci | 5 | 5 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 |
γ streptococci | 3 | 1 | 0 | 2 | 0 | 0 | 0 | 0 | 0 | 0 |
Streptococcus pneumoniae | 1 | 1 | 2 | 2 | 0 | 0 | 1 | 0 | 2 | 1 |
Streptococcus agalactiae (Group B) | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Streptococcus dysgalactiae | 0 | 0 | 2 | 1 | 0 | 0 | 1 | 3 | 0 | 0 |
Streptococcus pyogenes (Group A) | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Corynebacterium species | 22 | 14 | 33 | 26 | 3 | 4 | 19 | 20 | 8 | 5 |
Enterococcus faecalis | 4 | 7 | 3 | 3 | 2 | 1 | 6 | 6 | 0 | 2 |
Haemophilus influenzae | 2 | 2 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
Haemophilus species | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 |
Morganella morganii | 0 | 3 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 0 |
Proteus vulgaris | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Proteus species | 0 | 1 | 0 | 1 | 0 | 0 | 1 | 1 | 0 | 0 |
Escherichia coli | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 |
Enterobacter species | 0 | 0 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 |
Chryseobacterium indologenes | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 0 |
Serratia marcescens | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 |
Pseudomonas aeruginosa | 0 | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 |
Pseudomonas species | 2 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Neisseria species | 0 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
Moraxella species | 0 | 2 | 3 | 0 | 0 | 0 | 1 | 1 | 0 | 1 |
Klebsiella pneumoniae | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Klebsiella species | 0 | 1 | 2 | 1 | 0 | 0 | 0 | 1 | 1 | 0 |
Citrobacter koseri | 0 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 2 | 1 |
Bacillus cereus | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 |
Providencia rettgeri | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 |
Acinetobacter species | 0 | 0 | 1 | 3 | 0 | 0 | 1 | 0 | 0 | 0 |
Delftia acidovorans | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 |
Aeromonas hydrophila | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 0 |
Pasteurella multocida | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
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Matsuo, T.; Iguchi, M.; Morisato, N.; Murasako, T.; Hagiya, H. Are Prophylactic Systemic Antibiotics Required in Patients with Cataract Surgery at Local Anesthesia? Int. J. Environ. Res. Public Health 2022, 19, 15796. https://doi.org/10.3390/ijerph192315796
Matsuo T, Iguchi M, Morisato N, Murasako T, Hagiya H. Are Prophylactic Systemic Antibiotics Required in Patients with Cataract Surgery at Local Anesthesia? International Journal of Environmental Research and Public Health. 2022; 19(23):15796. https://doi.org/10.3390/ijerph192315796
Chicago/Turabian StyleMatsuo, Toshihiko, Masahiro Iguchi, Noriyasu Morisato, Tatsuya Murasako, and Hideharu Hagiya. 2022. "Are Prophylactic Systemic Antibiotics Required in Patients with Cataract Surgery at Local Anesthesia?" International Journal of Environmental Research and Public Health 19, no. 23: 15796. https://doi.org/10.3390/ijerph192315796