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Graefe's Archive for Clinical and Experimental Ophthalmology

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18.05.2023 | Medical Ophthalmology

Topical antibiotic prophylaxis before intravitreal injections: a pilot study

verfasst von: Edoardo Trovato Battagliola, Rodolfo Javier Riveros Cabral, Gregorio Manco, Gianluca Puggioni, Claudio Brancato, Pietro Mangiantini, Floriana Testa, Mariaelena Malvasi, Giammarco Raponi, Paolo Turchetti, Fernanda Pacella, Elena Pacella

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 10/2023

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Abstract

Purpose

To explore whether topical antibiotic prophylaxis in patients scheduled for intravitreal injections achieves surface sterility in a greater proportion of subjects as compared to povidone-iodine alone.

Material and methods

A randomized, triple-blind clinical trial. Population: patients scheduled for intravitreal injections for maculopathy. Inclusion criteria: any sex and race, age 18 years and above. Subjects were randomized into 4 groups: the first group applied chloramphenicol (CHLORAM), the second netilmicin (NETILM), the third a commercial ozonized antiseptic solution (OZONE), and the fourth applied no drops (CONTROL). Outcome variable: percentage of non-sterile conjunctival swabs. Specimens were collected before and after the application of 5% povidone-iodine moments before the injection.

Results

Ninety-eight subjects (33.7% females, 64.3% males), mean age: 70.2 ± 9.3 years (54–91). Before povidone-iodine, both the CHLORAM and NETILM group showed a lower percentage of non-sterile swabs (61.1% and 31.3% respectively), as compared to the OZONE (83.3%) and CONTROL (86.5%) groups (p < .04). However, this statistical difference was lost after the application of povidone-iodine for 3 min. Percentage of non-sterile swabs in each group after applying 5% povidone-iodine: CHLORAM 11.1%, NETILM 12.5%, CONTROL 15.4%, OZONE 25.0%. This was not statistically significant (p > .05).

Conclusions

Topical antibiotic prophylaxis with chloramphenicol or netilmicin drops decreases the bacterial load on the conjunctiva. However, after the application of povidone-iodine, all groups showed a significant reduction in the percentage of non-sterile swabs, and this value was comparable among all groups. For this reason, authors conclude that povidone-iodine alone is sufficient and prior topical antibiotic prophylaxis is not indicated.

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Titel: Topical antibiotic prophylaxis before intravitreal injections: a pilot study
verfasst von: Edoardo Trovato Battagliola
Rodolfo Javier Riveros Cabral
Gregorio Manco
Gianluca Puggioni
Claudio Brancato
Pietro Mangiantini
Floriana Testa
Mariaelena Malvasi
Giammarco Raponi
Paolo Turchetti
Fernanda Pacella
Elena Pacella
Publikationsdatum: 18.05.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 10/2023
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-023-06113-1

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Springer Medizin

Topical antibiotic prophylaxis before intravitreal injections: a pilot study

Abstract

Purpose

Material and methods

Results

Conclusions

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