cefotaxime and Endophthalmitis

To ascertain whether 0.4 mL of cefotaxime 0.25% applied intracamerally causes toxic alteration of the human corneal endothelium.. In this prospective randomized masked study, 66 patients had cataract extraction using phacoemulsification, a frown incision, and implantation of a poly(methyl methacrylate) intraocular lens. This was followed by intraocular injection of 0.4 mL of cefotaxime 0.25% or balanced salt solution (BSS(R)). Contact specular microscopy and photography were performed preoperatively and 1 to 4 days and 3 months postoperatively.. In the cefotaxime group, the mean endothelial cell count was 2729 cells/mm(2) +/- 474 (SD) preoperatively, 2520 +/- 462 cells/mm(2) 1 to 4 days postoperatively, and 2560 +/- 495 cells/mm(2) 3 months postoperatively. The mean endothelial cell count in the BSS (control) group was 2657 +/- 413 cells/mm(2), 2475 +/- 384 cells/mm(2), and 2486 +/- 427 cells/mm(2), respectively. There was no significant difference in cell count or morphology between groups (P <.05).. Intraocular application of cefotaxime produced no significant changes in endothelial cell count or morphology when compared with application of a control substance. With its broad spectrum of antibiotic activity, cefotaxime might be an appropriate alternative to other intraocularly administered antibiotics in anterior segment surgery for prophylaxis and management of infection.

Topics: Adult; Aged; Aged, 80 and over; Anterior Chamber; Cefotaxime; Cell Count; Cell Size; Cephalosporins; Double-Blind Method; Endophthalmitis; Endothelium, Corneal; Female; Humans; Lens Implantation, Intraocular; Male; Middle Aged; Phacoemulsification; Prospective Studies

Topics: Adolescent; Anti-Bacterial Agents; Cataract Extraction; Cefotaxime; Ceftazidime; Ciprofloxacin; Drug Therapy, Combination; Endophthalmitis; Endotamponade; Eye Infections, Bacterial; Haemophilus Infections; Haemophilus influenzae; Humans; Immunocompromised Host; Infusions, Intravenous; Intravitreal Injections; Male; Slit Lamp Microscopy; Visual Acuity; Vitreous Body

Topics: Blindness; Cefotaxime; Endocarditis; Endophthalmitis; Humans; Intravitreal Injections; Male; Meningitis; Middle Aged; Pneumonia; Sepsis; Streptococcal Infections; Streptococcus pneumoniae

To present a patient who developed bilateral endogenous endophthalmitis secondary to Streptococcus pneumoniae meningitis.. A 44-year-old man who was unconscious because of bacterial meningitis was referred to us for conjunctival hyperemia and decreased pupillary light reflexes. Ophthalmoscopy revealed inflammation in the anterior chamber and vitreous opacities in both eyes. He was diagnosed as having endogenous endophthalmitis associated with the meningitis. Ceftazidime and vancomycin hydrochloride were injected intravitreally and subconjunctivally repeatedly in both eyes.. Vision improved to 20/200 in the left eye 1 month later, but the right eye became hypotonic and blind. Vision deteriorated to light perception in the left eye due to a retinal detachment with proliferative vitreoretinopathy, and vitreous surgery successfully reattached the retina. Vision recovered to 20/80, and the retina has remained attached for 1 year.. We recommend that endogenous endophthalmitis be suspected in cases of meningitis, and if present, intravitreal and subconjunctival antibiotics should be promptly given to preserve vision.

Topics: Adult; Ampicillin; Anti-Bacterial Agents; Bacteremia; Cefotaxime; Ceftazidime; Cerebrospinal Fluid; Drug Therapy, Combination; Endophthalmitis; Eye Infections, Bacterial; Functional Laterality; Humans; Male; Meningitis, Pneumococcal; Retinal Detachment; Scleral Buckling; Streptococcus pneumoniae; Vancomycin; Visual Acuity; Vitrectomy; Vitreoretinopathy, Proliferative

Topics: Anti-Bacterial Agents; Cataract; Cefotaxime; Endophthalmitis; Eye Infections, Bacterial; Female; Gestational Age; Humans; Infant, Newborn; Infant, Premature, Diseases; Infant, Very Low Birth Weight; Klebsiella Infections; Klebsiella pneumoniae; Ultrasonography

Endophthalmitis subsequent to Klebsiella sepsis leads to functional blindness in most cases and is very difficult to treat. Every successful therapeutic modality can therefore help in creating an optimal therapeutic plan.. A 69-year old diabetic patient exhibited bilateral Klebsiella endophthalmitis with sepsis after a pneumonia. Two intravenous antibiotics were used: aminoglycosides (Gentamycin) and cephalosporins (Cefotaxim or Cefuroxim) with local parabulbar injections of Prednisolon. The long-term follow-up of four years provided some overview of morphological aspects of the development of endophthalmitis. Characteristic greyish hypopyon was seen in both eyes, which was more pronounced in the left eye than in the right. The left eye became phthisic. After resorption of the hypopyon in the right eye and prolonged resorption of the subretinal abscess for 9 months a useful visual acuity at 0.2 was achieved. Two years after the endophthalmitis a cataract surgery with implantation of a posterior chamber silicon lens was performed and good visual acuity (0.6) was achieved. After four years, the subretinal abscess left an extremely large, sharp bordered, unpigmented scar up to the sclera.. An early diagnosis and adequate long-time antibiotic therapy under the co-operative supervision of an ophthalmologist with internist appears to be most important for the therapeutic success in Klebsiella endophthalmitis.

Topics: Abscess; Aged; Cefotaxime; Cefuroxime; Drug Therapy, Combination; Endophthalmitis; Follow-Up Studies; Gentamicins; Humans; Klebsiella Infections; Lenses, Intraocular; Long-Term Care; Male; Ophthalmoscopy; Pneumonia, Bacterial; Prednisolone; Retinal Diseases; Sepsis

The present paper is a report of a 14-month-old boy who presented with fever, coryzal symptoms and red eyes. The patient developed a generalized tonic clonic convulsion on day 2 of his illness. Ophthalmological assessment demonstrated bilateral hypopyon and vitreous opacity resulting from endophthalmitis. Cerebrospinal fluid was positive for Neisseria meningitidis (A, C, Y, W 135) by latex agglutination. He was treated with high dose intravenous cefotaxime and intravitreal ceftazidime. He made good recovery and his vision was preserved. In view of the potential morbidity and mortality associated with systemic meningococcal infection, the presence of red eye and hypopyon provides important diagnostic clues indicating the need to investigate beyond superficial conjunctivitis. It should prompt the clinician to recognize endopthalmitis early and accurately diagnose this serious disease.

Topics: Anti-Infective Agents; Cefotaxime; Ceftazidime; Endophthalmitis; Humans; Infant; Male; Meningococcal Infections; Neisseria meningitidis; Vitreous Body

Topics: Ampicillin; Cefazolin; Cefotaxime; Diarrhea; Endophthalmitis; Eye; Eye Diseases; Female; Gentamicins; Humans; Infant; Salmonella; Salmonella Infections

Infectious endophthalmitis is a serious complication following cataract surgery, since it often induces a substantial reduction of visual acuity.. We retrospectively evaluated the clinical data of 53 patients with endophthalmitis following cataract surgery who were treated at the department of ophthalmology of the University Hospital in Ulm between 1995 and May 2001. Of these patients, 50 had been referred. Clinical presentation, infecting organism, treatment and visual outcome were analysed with a followup ranging from 2 weeks up to 42 months (median: 6 months).. In 52 patients endophthalmitis was preceeded by cataract extraction and IOL implantation, in one case by secondary IOL implantation. Confirmed microbiologic growth was demonstrated from intraocular specimens in 26 out of 41 operated eyes (63%), the most frequent causative organisms were coagulase-negative Staphylococci (50%). All isolated bacteria were sensitive to a combination of the antibiotics vancomycin and amikacin or vancomycin and ceftazidime. 13 patients were treated with intravenous antibiotic therapy alone. In 46% of patients, who were initially treated with intraocular antibiotic injections alone, required further therapeutic intervention for recurrent infection. Only 7.7% of the patients who initially underwent intraocular antibiotic injections combined with IOL removal or pars plana vitrectomy with or without IOL removal, required further surgical intervention. Initial visual acuity was hand movements (median) only but improved during follow-up to 0.2 (median).. In this series all tested bacteria were susceptible to the combination of vancomycin with either amikacin or ceftazidime. Aggressive initial treatment including IOL removal may be associated with a lower frequency of recurrent disease.

Topics: Amikacin; Cefotaxime; Ceftazidime; Combined Modality Therapy; Drug Therapy, Combination; Endophthalmitis; Follow-Up Studies; Humans; Infusions, Intravenous; Lenses, Intraocular; Postoperative Complications; Prosthesis-Related Infections; Recurrence; Reoperation; Retrospective Studies; Staphylococcal Infections; Vancomycin; Visual Acuity; Vitrectomy

Topics: Bacteremia; Cefotaxime; Child, Preschool; Disseminated Intravascular Coagulation; Endophthalmitis; Eye Infections, Bacterial; Female; Humans; Meningococcal Infections; Neisseria meningitidis; Vitrectomy; Vitreous Body; Vitreous Hemorrhage

To highlight an unusual organism causing a unilateral endophthalmitis by transplacental spread.. We report a case of Plesiomonas shigelloides endophthalmitis, presenting in a newborn, with co-existing septicaemia and meningitis. There was a significant maternal history of diarrhoea associated with the ingestion of oysters 2 weeks prior to delivery.. The endophthalmitis was treated with parenteral antibiotics and topical mydriatics with complete resolution, although subsequent assessment of the affected eye suggests a poor visual outcome.. Endophthalmitis in the newborn is an unusual clinical finding and usually presents with other manifestations of bacteraemia. Plesiomonas shigelloides is fortunately an infrequent cause of neonatal infection, but is associated with a high degree of morbidity and mortality. We postulate that this neonate acquired P. shigelloides via the transplacental route, and suggest that this organism be included in the list of 'other' causes of transplacental infection that has been abbreviated to 'O' in the acronym 'TORCH'.

Topics: Animals; Bacteremia; Cefotaxime; Cephalosporins; Cyclopentolate; Endophthalmitis; Eye Infections, Bacterial; Female; Food Microbiology; Gram-Negative Bacterial Infections; Humans; Infant, Newborn; Male; Maternal-Fetal Exchange; Meningitis, Bacterial; Mydriatics; Ostreidae; Plesiomonas; Pregnancy; Pregnancy Complications, Infectious

Topics: Anti-Bacterial Agents; Cefazolin; Cefotaxime; Emphysema; Endocarditis; Endophthalmitis; Escherichia coli Infections; Fatal Outcome; Gentamicins; Humans; Male; Middle Aged; Oxacillin; Sepsis; Urinary Tract Infections

The concentrations of gentamicin and cefotaxime (claforan) in the humor of the anterior chamber and vitreous body of the eye were estimated in the study on the pharmacokinetics of the antibiotics in rabbits. The antibiotics were administered intravitreally in single doses. It was shown that the residence time of the antibiotics in the therapeutic concentrations in the eye cavity was 48 hours. Cefotaxime proved to be the most efficient agent in the prevention and treatment of postoperative endophthalmitis.

Topics: Administration, Topical; Animals; Cefotaxime; Endophthalmitis; Gentamicins; Postoperative Complications; Rabbits; Vitreous Body

Experimental endophthalmitis was treated with single intravitreous administrations of cefotaxime (claforan) and gentamicin. It was found that a single administration of cefotaxime to the vitreous body prevented development of endophthalmitis in rabbits previously infected with Staphylococcus aureus, E. coli and Pseudomonas aeruginosa. Vitrectomy in the treatment of endophthalmitis was shown to be promising and provide satisfactory anatomical and functional results.

Topics: Animals; Cefotaxime; Endophthalmitis; Escherichia coli Infections; Gentamicins; Pseudomonas Infections; Rabbits; Staphylococcal Infections; Vitrectomy; Vitreous Body

A 72-year-old white man who had undergone surgical trabeculectomy and extracapsular cataract extraction with a posterior-chamber lens implantation in the left eye suffered from chronic iridocyclitis for eight months. He subsequently presented with acute hypopyon and vitritis. Anterior-chamber and vitreous cultures were positive for Pseudomonas cepacia. The infection was successfully treated with subconjunctival piperacillin, intravitreal cefotaxime, and intravenous piperacillin and gentamicin. To our knowledge, this is the first documented case of Pseudomonas cepacia endophthalmitis.

Topics: Aged; Cataract Extraction; Cefotaxime; Endophthalmitis; Gentamicins; Glaucoma; Humans; Iritis; Laser Therapy; Lenses, Intraocular; Male; Penicillin Resistance; Piperacillin; Pseudomonas; Pseudomonas Infections; Recurrence; Surgical Wound Infection; Trabecular Meshwork; Vitreous Body

Topics: Bacterial Infections; Cefotaxime; Endophthalmitis; Eye Diseases; Humans; Injections, Intravenous; Kinetics; Vitrectomy; Vitreous Body

The penetration of cefotaxime, a new semi-synthetic cephalosporin, into human aqueous humour was investigated. Doses of 1 g (17 patients) and 2 g (19 patients) were administered intravenously at time intervals varying from 45 min to 4 h prior to routine cataract surgery. After the 2 g dosage the average concentration of cefotaxime in the aqueous humour was higher (P less than 0.05) and lasted longer than after the 1 g dosage. The highest average concentration in the aqueous humour after the 1 g dosage was 1.85 microgram/ml, 3.95 micrograms/ml after the 2 g dosage. Therapeutic levels were consistently found in both groups for the organisms most commonly responsible for bacterial endophthalmitis, except for Pseudomonas aeruginosa and Staphylococcus epidermidis.

Topics: Aqueous Humor; Bacterial Infections; Cataract Extraction; Cefotaxime; Cephalosporins; Endophthalmitis; Humans; Injections, Intravenous; Kinetics