ANTIBIOTIC SELECTION IN THE TREATMENT OF ENDOPHTHALMITIS - THE SIGNIFICANCE OF DRUG-COMBINATIONS AND SYNERGY

Emerging resistance of organisms to standard antibiotic therapy has fo rced clinicians to continually evaluate the best intraocular antibioti cs for the treatment of endophthalmitis. Early diagnosis and appropria te treatment with intraocular antibiotics are important factors in the successful management of endophthalmitis. Although drug combinations are necessary to cover the full range of bacteria causing endophthalmi tis, antimicrobial synergy is probably less important in endophthalmit is treatment because of the high intravitreal concentration of individ ual antibiotics achieved by intravitreal injection. In the treatment o f bacterial endophthalmitis, the combination of intravitreal vancomyci n (1 mg/0.1 cc) and ceftazidime (2.25 mg/0.1 cc) is a reasonable alter native to the combination vancomycin and amikacin (0.4 mg/0.1 cc). (C) 1997 by Elsevier Science Inc.