Antibiotics Drops Do Not Provide Protection in Preventing Infections after Intraocular Injections

What is the Data to Support Discontinuing Their Use in Preventing Infections after Intraocular Injections?

Recently, the Diabetic Retinopathy Clinical Research network reported on a series of 8,027 intraocular injections in 1,066 eyes across 4 of their clinical trials. Seven cases of endophthalmitis (eye infection) occurred, including 6 among 4,694 (0.13%) in eyes in which topical antibiotics were used compared to 1 among 3,333 (0.03%) in eyes in which topical antibiotics were NOT used. This supports that topical antibiotics are not protective of eye infections in intraocular injection procedures. Furthermore, there is the additional expense, eye irritation, and potential contamination of the bottle.

Why Were We Recommending Them Previously?

There has been much controversy regarding the effectiveness of antibiotic prophylaxis in preventing infections after intraocular injections. At Retina Associates of Florida we were recommending their use for two main reasons: 1) the major clinical trials of intraocular injections required them, 2) if there is a controversial question, we always prefer to take the side of safety.

What are the KNOWN Procedures to Prevent Infection From Intraocular Injections?

  • Betadine (povidone-iodine) solution to injection site
  • Sterile lid speculum to protect from lashes