Post-traumatic endophthalmitis prophylaxis: a systematic review and meta-analysis

Purpose The goal of this study is to determine if certain aspects of endophthalmitis prophylaxis strategies are superior to others. Design This investigation is a systematic review and meta-analysis. Methods All studies specifying a type of prophylaxis strategy and resulting rates of endophthalmitis were included. Time course, method of administration, and antibiotic regimen, and confounding factors were collected and included for meta-regression. Results Time courses greater than 24 h did not significantly improve outcomes. Likewise, intraocular and/or intravenous antibiotic administration methods did not significantly outperform oral administration. No antibiotic regimens performed differently from vancomycin/ >= 3(rd) generation cephalosporin except for ciprofloxacin monotherapy which yielded significantly worse outcomes. Conclusions Future antibiotic strategies should strongly consider the risks of antibiotic treatment > 24 h and administration methods other than the oral antibiotic forms. In addition, providers should be wary of using ciprofloxacin monotherapy for endophthalmitis prophylaxis when treating open globe injuries.