Posters

Current practice in antibiotic prophylaxis of postoperative endophthalmitis in cataract surgery, East of England

Poster Details

First Author: M. Chou UK

Co Author(s): C. Papandreou   M. Arjunan   T. Nixon   A. Singh           

Abstract Details

Purpose:

Current European guidelines recommend intracameral cefuroxime for antibiotic prophylaxis in cataract surgery; and this has now been widely adopted in the UK. However, in patients who have an allergy to penicillin practice varies because of existing concerns of cross-reactivity. The purpose of this study is to assess current practice in antibiotic prophylaxis of post-operative endophthalmitis in cataract surgery, particularly examining antibiotic choice for patients with reported penicillin allergy in the East of England.

Setting:

Lister Hospital, East and North Hertfordhire NHS Trust

Methods:

Anonymous survey of ophthalmologists within the East of England region. Questions addressed routine antibiotic choice in cataract surgery, prescribing for patients with allergies, and existence and use of local guidelines. Responses were received from 27 surgeons; 11 independent and 16 in training, from teaching (32%) and district general hospitals (68%). Data were analysed using Microsoft Excel 2007.

Results:

Twenty-one of 27 surgeons routinely give intracameral cefuroxime in cataract surgery, 5 give intracameral vancomycin and 1 reports giving only topical chloramphenicol. For patients with a reported penicillin allergy the number of surgeons who administer intracameral cefuroxime drops to 18 and falls to only 3 in those patients with a history of penicillin anaphylaxis. This is replaced with intracameral vancomycin, subconjunctival gentamicin, or topical antibiotics. Twenty-three respondents work in a department without a policy or are not aware of a policy.

Conclusions:

Variability exists in the practice of antibiotic prophylaxis of endophthalmitis post cataract surgery in the East of England region. This is even more marked for patients with a penicillin allergy. This variability within one region may well be replicated throughout the country in a significant way. This assessment of current practice suggests a need for a nationwide study to look for any geographical variation and whether variation in practice is associated with rates of post-cataract endophthalmitis.

Financial Disclosure:

None