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The experimental and clinical use of intravitreal antibiotics to treat bacterial and fungal endophthalmitis

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Abstract

The experimental data involving the use of 14 antibacterial and two antifungal agents have been used to establish a rationale for the management of human endophthalmitis. Twelve cases of endophthalmitis treated under our supervision have been described in detail. The eventual visual outcome is related to two factors: (1) time interval between diagnosis and institution of adequate therapy, and (2) the severity of the organism and its ability to produce exotoxins and proteolytic enzymes. Eleven of 12 cases were cured with the recommended dosages of gentamicin and dexamethasone (400 mcg and 360 mcg, respectively). Eight of the 12 patients retained useful vision of 20/200 or better.

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References

  • Allen, H.F. & A.B. Mangiaracine. Bacterial endophthalmitis after cataract extraction: A study of 22 infections in 20,000 operations.Arch. Ophthalmol. 72:454 (1964).

    Google Scholar 

  • Allen, H.F. & A.B. Mangiaracine. Bacterial endophthalmitis after cataract extraction: II. Incidence in 36,000 consecutive operations with special reference to preoperative topical antibiotics.Trans. Am. Acad. Ophthalmol. Otolaryngol. 77:OP 581 (1973).

    Google Scholar 

  • Axelrod, A.J., G.A. Peyman & D.J. Apple. Toxicity of intravitreal injection of amphotericin B.Am. J. Ophthalmol. 76:578 (1973).

    Google Scholar 

  • Axelrod, A.J. & G.A. Peyman. Intravitreal amphotericin B treatment of experimental fungal endophthalmitis.Am. J. Ophthalmol. 76:584(1973).

    Google Scholar 

  • Barza, M., J. Baum, B. Birkby & L. Weinstein. Intraocular penetration of carbenicillin in the rabbit.Am. J. Ophthalmol. 75:307 (1973).

    Google Scholar 

  • Batko, K.A. & G.A. Peyman. Intravitreal flucytosine. Unpublished data.

  • Becker, E.F. The intraocular penetration of lincomycin.Am. J. Ophthalmol. 67:963 (1969).

    Google Scholar 

  • Bennett, T.O. & G.A. Peyman. Use of tobramycin in eradicating experimental bacterial endophthalmitis.von Graefe's Arch. Klin. Exp. Ophthalmol. 191:93 (1974).

    Google Scholar 

  • Blecker, G.M. & E.R. Maas. The penetration of aureomycin, terramycin and choramphenicol in the ocular tissues.Ophthalmologica 130:1 (1955).

    Google Scholar 

  • Christensen, L. & P.J. Robinson. Late infection of filtration blebs.Trans. Pac. Coast. Otoophthalmol. Soc. 44:95 (1963).

    Google Scholar 

  • Coles, R.S., G.L. Boyle, I.H. Leopold & S.S. Schnierson. Lincomycin levels in rabbit ocular fluids and serum.Am. J. Ophthalmol. 72:464 (1971).

    Google Scholar 

  • Daily, M.J., G.A. Peyman & G. Fishman. Intravitreal injection of methicillin for treatment of endophthalmitis.Am. J. Ophthalmol. 76:343 (1973).

    Google Scholar 

  • Deur, H.A. & E.R. Maas. The penetration of several new penicillins into the tissue of the eye.Ophthalmologica 144:316 (1962).

    Google Scholar 

  • Feigenbaum, A. & W. Kornbluth. Intravitreal injection of penicillin in a case of incipient abscess of the vitreous following extracapsular cataract extraction: Perfect cure.Ophthalmologica 110:300 (1945).

    Google Scholar 

  • Forster, R.K. Endophthalmitis: Diagnostic cultures and visual results.Arch. Ophthalmol. 92:386 (1974).

    Google Scholar 

  • Furgiuele, F.P., T.W. Sery & I.H. Leopold. Newer antibiotics: Their ocular penetration.Am. J. Ophthalmol. 50:614 (1960).

    Google Scholar 

  • Furgiuele, F.P. New antibiotics: Their ocular penetration: II.Am. J. Ophthalmol. 58:443 (1964).

    Google Scholar 

  • Furgiuele, F.P. Ocular penetration and tolerance of gentamicin.Am. J. Ophthalmol. 64:421 (1967).

    Google Scholar 

  • Golden, B. & S.P. Coppel. Ocular tissue absorption of gentamicin.Arch. Ophthalmol. 84:792 (1970).

    Google Scholar 

  • Graham, R.O. & G.A. Peyman. Intravitreal injection of dexamethasone: Treatment of experimentally induced endophthalmitis.Arch. Ophthalmol. 92:149 (1974).

    Google Scholar 

  • Graham, R.O., G.A. Peyman & G. Fishman. Intravitreal injection of cephaloridine in treatment of endophthalmitis.Arch. Ophthalmol. 93:56 (1975).

    Google Scholar 

  • Green, W.R., J.E. Bennett & R.D. Goos. Ocular penetration of amphotericin B.Arch. Ophthalmol. 73:769 (1965).

    Google Scholar 

  • Green, W.R. & I.H. Leopold. Intraocular penetration of methicillin.Am. J. Ophthalmol. 60:800 (1965).

    Google Scholar 

  • Hattenhauer, J.M. & M.P. Lipsich. Late endophthalmitis after filtering surgery.Am. J. Ophthalmol. 72:1097 (1971).

    Google Scholar 

  • Homer, P., G.A. Peyman, J. Koziol & D. Sanders. Intravitreal injection of vancomycin in experimental staphylococcal endophthalmitis.Acta Ophthalmol., in press.

  • Homer, P. & G.A. Peyman. Intravitreal ampicillin. Unpublished data.

  • Kasbeer, R.T., P. Homer & G.A. Peyman. Intravitreal oxacillin. In press.

  • Kasbeer, R.T., G.A. Peyman & P. Homer. Penetration of gentamicin and amikacin in the aphakic eye.Von Graefe's Arch. Klin. Exp. Ophthalmol., in press.

  • Kirk, H.Q. Cauterization of filtering blebs following cataract extraction.Trans. Am. Acad. Ophthalmol. Otolaryngol. 77:573 (1973).

    Google Scholar 

  • Koziol, J. & G.A. Peyman. Intraocular chloramphenicol and bacterial endophthalmitis.Can. J. Ophthalmol. 9:316 (1974).

    Google Scholar 

  • Kurose, Y. & I.H. Leopold. Intraocular penetration of ampicillin.Arch. Ophthalmol. 73:361 (1965).

    Google Scholar 

  • Leopold, I.H. Intravitreal penetration of penicillin and penicillin therapy of infections of the vitreous.Arch. Ophthalmol. 33:211 (1945).

    Google Scholar 

  • Leopold, I.H. Clinical trial with chloramphenicol in ocular infections.Arch. Ophthalmol. 45:44 (1951).

    Google Scholar 

  • Leopold, I.H., A.C. Nichols & A.W. Vogel. Penetration of chloramphenicol into the eye.Arch. Ophthalmol. 44:22 (1950).

    Google Scholar 

  • May, D.R., E.S. Ericson & G.A. Peyman. Intraocular injection of gentamicin: Single injection therapy of experimental bacterial endophthalmitis.Arch. Ophthalmol. 91:487 (1974).

    Google Scholar 

  • Meisels, H.I. & G.A. Peyman. Intravitreal erythromycin treatment of induced staphylococcal endophthalmitis.Ann. Ophthalmol., in press.

  • Naib, K., J.W. Hallett & I.H. Leopold. Observations on the ocular effects of erythromycin.Am. J. Ophthalmol. 39:395 (1955).

    Google Scholar 

  • Nelsen, P., G.A. Peyman & T.O. Bennett. BB-K8: A new aminoglycoside for intravitreal injection in bacterial endophthalmitis.Am. J. Ophthalmol. 78:82 (1974).

    Google Scholar 

  • Neveu, M. & A.J. Elliot. Prophylaxis and treatment of endophthalmitis.Am. J. Ophthalmol. 48:368 (1959).

    Google Scholar 

  • Paque, J.T. & G.A. Peyman. Intravitreal clindamycin in the treatment of vitreous infection.Ophthalmic Surg. 5:34 (1974).

    Google Scholar 

  • Peyman, G.A. & R. Herbst. Bacterial endophthalmitis: Treatment with intraocular injection of gentamicin and dexamethasone.Arch. Ophthalmol. 91:416 (1974).

    Google Scholar 

  • Peyman, G.A., D.R. May & E.S. Ericson. Intraocular injection of gentamicin: Toxic effects and clearance.Arch. Ophthalmol. 92:42 (1974).

    Google Scholar 

  • Peyman, G.A., P. Nelsen & T.O. Bennett. Intravitreal injection of kanamycin in experimentally induced endophthalmitis.Can. J. Ophthalmol. 9:322 (1974).

    Google Scholar 

  • Peyman, G.A., J.T. Paque, H.I. Meisels & T.O. Bennett. Postoperative endophthalmitis: A comparison of methods for treatment and prophylaxis with gentamicin.Ophthalmic Surg. 6:45 (1975).

    Google Scholar 

  • Peyman, G.A., D.W. Vastine, E.R. Crouch & R.W. Herbst. Clinical use of intravitreal antibiotics to treat bacterial endophthalmitis.Trans. Am. Acad. Ophthalmol. Otolaryngol. 78:OP862 (1974).

    Google Scholar 

  • Pryor, J.G., L. Apt & I.H. Leopold. Intraocular penetration of vancomycin.Arch. Ophthalmol. 67:608 (1962).

    Google Scholar 

  • Purnell, W.D. and S.D. McPherson Jr. The effect of tobramycin on rabbit eyes.Am. J. Ophthalmol. 77:578 (1974).

    Google Scholar 

  • Ryan, K.J., F.D. Schoenknecht & W.M.M. Kirby. Disc sensitivity testing.Hosp. Pract. 5:91 (1970).

    Google Scholar 

  • Rycroft, B.W. Penicillin and the control of deep intraocular infection.Br. J. Ophthalmol. 29:57 (1945).

    Google Scholar 

  • Schenk, A.G. & G.A. Peyman. Lincomycin by direct intravitreal injection in the treatment of experimental bacterial endophthalmitis.von Graefe's Arch. Klin. Exp. Ophthalmol. 190:281 (1974).

    Google Scholar 

  • Schenk, A.G., G.A. Peyman & J.T. Paque. The intravitreal use of carbenicillin for treatment ofPseudomonas endophthalmitis.Acta Ophthalmol. 52:707 (1974).

    Google Scholar 

  • Schneider, J. & S.S. Frankel. Treatment of late postoperative intraocular infections with intraocular injection of penicillin.Arch. Ophthalmol. 37:304 (1947).

    Google Scholar 

  • Theodore, F.H. Bacterial endophthalmitis after cataract surgery.Int. Ophthalmol. Clin. 4:839 (1964).

    Google Scholar 

  • Von Sallmann, L., K. Meyer & J. di Grandi. Experimental study on penicillin treatment of ectogenous infection of vitreous.Arch. Ophthalmol. 32:179 (1944).

    Google Scholar 

  • Von Sallmann, L. Penicillin therapy of infections of the vitreous.Arch. Ophthalmol. 33:455 (1945a).

    Google Scholar 

  • Von Sallmann, L. Penetration of penicillin into the eye: Further studies.Arch. Ophthalmol. 34:195 (1945b).

    Google Scholar 

  • Yannuzzi, L.A. & F.H. Theodore. Cryotherapy of post-cataract blebs.Am. J. Ophthalmol. 76:317 (1973).

    Google Scholar 

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Authors and Affiliations

  1. Chicago, USA

    Gholam A. Peyman M.D., David W. Vastine & Henry I. Meisels

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  1. Gholam A. Peyman M.D.
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  2. David W. Vastine
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  3. Henry I. Meisels
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Additional information

Funded in part by the Bausch and Lomb Fellowship in External Disease (Dr. Vastine) and in part by Public Health Service Grant 1107-03 and the Illinois Lions Club.

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Peyman, G.A., Vastine, D.W. & Meisels, H.I. The experimental and clinical use of intravitreal antibiotics to treat bacterial and fungal endophthalmitis. Doc Ophthalmol 39, 183–201 (1975). https://doi.org/10.1007/BF00578762

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