Elsevier

Ophthalmology

Volume 96, Issue 12, December 1989, Pages 1722-1726
Ophthalmology

Rural Endophthalmitis

https://doi.org/10.1016/S0161-6420(89)32658-3Get rights and content

Abstract

The antibiotic regimens recommended for empiric use in posttraumatic endophthalmitis are based on data collected from medical centers in large metropolitan areas. In rural areas, trauma resulting in endophthalmitis frequently involves injuries with perforating objects that are contaminated with organic matter. These rural cases therefore may not be comparable with endophthalmitis occurring after nonrural injuries. A 10-year retrospective analysis was performed to investigate the incidence of rural endophthalmitis as well as determine the type of causative organisms. Endophthalmitis developed in 24 (30%) of 80 patients with rural penetrating trauma, compared with 23 (11%) of 204 patients with nonrural penetrating trauma. Of 24 patients, Bacillus spp were isolated in 11 (46%), followed by gram-negative rods in 7, Staphylococcus epidermidis in 6, and streptococcal species in 5. In 10 (42%) of these 24 patients with rural trauma, more than one organism was isolated. Bacillus spp were involved in six (60%) of ten of these mixed infections. Based on these findings, the authors suggest an intravitreal regimen of gentamicin along with either vancomycin or clindamycin for the empiric therapy of rural endophthalmitis.

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Presented as a poster at the American Academy of Ophthalmology Annual Meeting, Las Vegas, October 1988.

Supported in part by the Retina Research Fund of The University of Iowa and an unrestricted grant from Research to Prevent Blindness, Inc, New York.

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