Prophylactic antibiotics for postcataract surgery endophthalmitis: a systematic review and network meta-analysis of 6.8 million eyes
Abstract To reveal optimal antibiotic prophylactic regimen for postoperative endophthalmitis (POE), we conducted systematic review and network meta-analysis. A total of 51 eligible original articles, including two randomized controlled trials, were identified. In total, 4502 POE cases occurred in 6,...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-10-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-21423-w |
| _version_ | 1828096312878301184 |
|---|---|
| author | Ai Kato Nobuyuki Horita Ho Namkoong Eiichi Nomura Nami Masuhara Takeshi Kaneko Nobuhisa Mizuki Masaki Takeuchi |
| author_facet | Ai Kato Nobuyuki Horita Ho Namkoong Eiichi Nomura Nami Masuhara Takeshi Kaneko Nobuhisa Mizuki Masaki Takeuchi |
| author_sort | Ai Kato |
| collection | DOAJ |
| description | Abstract To reveal optimal antibiotic prophylactic regimen for postoperative endophthalmitis (POE), we conducted systematic review and network meta-analysis. A total of 51 eligible original articles, including two randomized controlled trials, were identified. In total, 4502 POE cases occurred in 6,809,732 eyes (0.066%). Intracameral injection of vancomycin had the best preventive effect (odds ratio [OR] 0.03, 99.6% confidence interval [CI] 0.00–0.53, corrected P-value = 0.006, P-score = 0.945) followed by intracameral injection of cefazoline (OR 0.09, 99.6% CI 0.02–0.42, corrected P-value < 0.001, P-score = 0.821), cefuroxime (OR 0.18, 99.6% CI 0.09–0.35, corrected P-value < 0.001, P-score = 0.660), and moxifloxacin (OR 0.36, 99.6% CI 0.16–0.79, corrected P-value = 0.003, P-score = 0.455). While one randomized controlled trial supported each of intracameral cefuroxime and moxifloxacin, no randomized controlled trial evaluated vancomycin and cefazoline. Sensitivity analysis focusing on the administration route revealed that only intracameral injection (OR 0.19, 99.4% CI 0.12–0.30, corrected P-value < 0.001, P-score = 0.726) significantly decreased the risk of postoperative endophthalmitis. In conclusion, intracameral injection of either vancomycin, cefazoline, cefuroxime, or moxifloxacin prevented POE. |
| first_indexed | 2024-04-11T07:28:27Z |
| format | Article |
| id | doaj.art-2281b66d761b429c85f2e11905813f3f |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-11T07:28:27Z |
| publishDate | 2022-10-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-2281b66d761b429c85f2e11905813f3f2022-12-22T04:37:01ZengNature PortfolioScientific Reports2045-23222022-10-0112111010.1038/s41598-022-21423-wProphylactic antibiotics for postcataract surgery endophthalmitis: a systematic review and network meta-analysis of 6.8 million eyesAi Kato0Nobuyuki Horita1Ho Namkoong2Eiichi Nomura3Nami Masuhara4Takeshi Kaneko5Nobuhisa Mizuki6Masaki Takeuchi7Department of Ophthalmology and Visual Science, Yokohama City University Graduate School of MedicineChemotherapy Center, Yokohama City University HospitalDepartment of Infectious Diseases, Keio University School of MedicineDepartment of Ophthalmology and Visual Science, Yokohama City University Graduate School of MedicineDepartment of Ophthalmology, Chigasaki Municipal HospitalDepartment of Pulmonology, Yokohama City University Graduate School of MedicineDepartment of Ophthalmology and Visual Science, Yokohama City University Graduate School of MedicineDepartment of Ophthalmology and Visual Science, Yokohama City University Graduate School of MedicineAbstract To reveal optimal antibiotic prophylactic regimen for postoperative endophthalmitis (POE), we conducted systematic review and network meta-analysis. A total of 51 eligible original articles, including two randomized controlled trials, were identified. In total, 4502 POE cases occurred in 6,809,732 eyes (0.066%). Intracameral injection of vancomycin had the best preventive effect (odds ratio [OR] 0.03, 99.6% confidence interval [CI] 0.00–0.53, corrected P-value = 0.006, P-score = 0.945) followed by intracameral injection of cefazoline (OR 0.09, 99.6% CI 0.02–0.42, corrected P-value < 0.001, P-score = 0.821), cefuroxime (OR 0.18, 99.6% CI 0.09–0.35, corrected P-value < 0.001, P-score = 0.660), and moxifloxacin (OR 0.36, 99.6% CI 0.16–0.79, corrected P-value = 0.003, P-score = 0.455). While one randomized controlled trial supported each of intracameral cefuroxime and moxifloxacin, no randomized controlled trial evaluated vancomycin and cefazoline. Sensitivity analysis focusing on the administration route revealed that only intracameral injection (OR 0.19, 99.4% CI 0.12–0.30, corrected P-value < 0.001, P-score = 0.726) significantly decreased the risk of postoperative endophthalmitis. In conclusion, intracameral injection of either vancomycin, cefazoline, cefuroxime, or moxifloxacin prevented POE.https://doi.org/10.1038/s41598-022-21423-w |
| spellingShingle | Ai Kato Nobuyuki Horita Ho Namkoong Eiichi Nomura Nami Masuhara Takeshi Kaneko Nobuhisa Mizuki Masaki Takeuchi Prophylactic antibiotics for postcataract surgery endophthalmitis: a systematic review and network meta-analysis of 6.8 million eyes Scientific Reports |
| title | Prophylactic antibiotics for postcataract surgery endophthalmitis: a systematic review and network meta-analysis of 6.8 million eyes |
| title_full | Prophylactic antibiotics for postcataract surgery endophthalmitis: a systematic review and network meta-analysis of 6.8 million eyes |
| title_fullStr | Prophylactic antibiotics for postcataract surgery endophthalmitis: a systematic review and network meta-analysis of 6.8 million eyes |
| title_full_unstemmed | Prophylactic antibiotics for postcataract surgery endophthalmitis: a systematic review and network meta-analysis of 6.8 million eyes |
| title_short | Prophylactic antibiotics for postcataract surgery endophthalmitis: a systematic review and network meta-analysis of 6.8 million eyes |
| title_sort | prophylactic antibiotics for postcataract surgery endophthalmitis a systematic review and network meta analysis of 6 8 million eyes |
| url | https://doi.org/10.1038/s41598-022-21423-w |
| work_keys_str_mv | AT aikato prophylacticantibioticsforpostcataractsurgeryendophthalmitisasystematicreviewandnetworkmetaanalysisof68millioneyes AT nobuyukihorita prophylacticantibioticsforpostcataractsurgeryendophthalmitisasystematicreviewandnetworkmetaanalysisof68millioneyes AT honamkoong prophylacticantibioticsforpostcataractsurgeryendophthalmitisasystematicreviewandnetworkmetaanalysisof68millioneyes AT eiichinomura prophylacticantibioticsforpostcataractsurgeryendophthalmitisasystematicreviewandnetworkmetaanalysisof68millioneyes AT namimasuhara prophylacticantibioticsforpostcataractsurgeryendophthalmitisasystematicreviewandnetworkmetaanalysisof68millioneyes AT takeshikaneko prophylacticantibioticsforpostcataractsurgeryendophthalmitisasystematicreviewandnetworkmetaanalysisof68millioneyes AT nobuhisamizuki prophylacticantibioticsforpostcataractsurgeryendophthalmitisasystematicreviewandnetworkmetaanalysisof68millioneyes AT masakitakeuchi prophylacticantibioticsforpostcataractsurgeryendophthalmitisasystematicreviewandnetworkmetaanalysisof68millioneyes |