Combined meropenem and linezolid as a systemic treatment for postoperative endophthalmitis

Tappeiner, Christoph; Schürch, Kaspar Werner; Goldblum, David; Zimmerli, Stefan; Fleischhauer, Johannes M.C.; Früh Epstein, Beatrice (2010). Combined meropenem and linezolid as a systemic treatment for postoperative endophthalmitis. Klinische Monatsblätter für Augenheilkunde, 227(4), pp. 257-61. Stuttgart: Ferdinand Enke Verlag 10.1055/s-0029-1245219

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PURPOSE The aim of this study was to evaluate the antibiotic treatment of postoperative endophthalmitis with combined systemic meropenem and linezolid. METHODS A retrospective analysis of endophthalmitis treated with systemic meropenem and linezolid compared to conventional systemic antibiotics by evaluation of outcome and adverse effects was carried out. RESULTS 26 patients with unilateral postoperative endophthalmitis with a systemic combination regimen of meropenem (2 g TID, mean duration of treatment 5.5 days) and linezolid (600 mg BID, mean duration of treatment 8.9 days) (group 1, mean follow-up time 140 days) were included in this study and compared to 45 postoperative endophthalmitis patients treated with conventional systemic antibiotics (group 2; mean follow-up time 320 days). In group 1, 69.2 % of eyes additionally received intravitreal amikacin and vancomycin (vs. 24.4 % in group 2; p < 0.001), in 92.3 % pars plana vitrectomy was performed (vs. 68.9 % in group 2, p = 0.047). Mean best corrected visual acuity improved from a baseline of 1.76 logMar for group 1 and 1.83 logMar for group 2 to 0.91 logMar (p = 0.0001) and 0.90 logMar (p < 0.0001), respectively, at the end of the follow-up, revealing no significant differences between the two groups at any time point (p > 0.05). Ocular complications were observed in 34.6 % of eyes in group 1 (vs. 37.8 % in group 2; p > 0.05). Adverse drug effects occurred significantly more frequently in group 1 (26.9 % vs. 4.4 % p = 0.02). CONCLUSION In spite of the reported better penetration through the blood-ocular barrier and the broader antibacterial spectrum of meropenem and linezolid, no benefit in outcome was found in the present study. In contrast, adverse effects and costs of the combination regimen were significantly higher.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases

UniBE Contributor:

Tappeiner, Christoph; Schürch, Kaspar Werner; Goldblum, David; Zimmerli, Stefan and Früh Epstein, Beatrice

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

0023-2165

Publisher:

Ferdinand Enke Verlag

Language:

English

Submitter:

Christoph Tappeiner

Date Deposited:

04 Oct 2013 14:08

Last Modified:

17 Mar 2015 19:08

Publisher DOI:

10.1055/s-0029-1245219

PubMed ID:

20408069

Web of Science ID:

000276863200006

URI:

https://boris.unibe.ch/id/eprint/303 (FactScience: 197478)

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