Artikel
Evidence-based medical therapy of postoperative endophthalmitis
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Autoren
Veröffentlicht: | 22. September 2004 |
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Gliederung
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Objective
The globe-threatening condition of postoperative endophthalmitis is a therapeutic challenge for the involved physician. Besides surgical intervention, medical therapy has been suggested and discussed as a therapeutic alternative.
Methods
A meta-analysis of all studies and reports on medical therapy of postoperative endophthalmitis was performed by the expert commission employing the Medline and PubMed databases.
Results
The Early Vitrectomy Study (EVS) is the only prospective randomized study addressing medical therapy of postoperative endophthalmitis. Due to its unsuitable study design, it does not answer the question of the optimal antiinfective drug regimen. Some valid results of different studies allow the conclusion that vancomycin is the most suitable agent for the treatment of grampositive pathogens and ceftacidime for gramnegative pathogens. Simultaneous application of systemic steroids is suggested to be useful.
Conclusions
So far, no prospective randomized studies on the medical therapy of postoperative endophthalmitis have been conducted. However, according to validated data of different studies, a combination therapy with different agents is advisable.