Document Detail


Combined meropenem and linezolid as a systemic treatment for postoperative endophthalmitis.
MedLine Citation:
PMID:  20408069     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
C Tappeiner; K Schuerch; D Goldblum; S Zimmerli; J C Fleischhauer; B E Frueh
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Publication Detail:
Type:  Journal Article     Date:  2010-04-20
Journal Detail:
Title:  Klinische Monatsbl?tter f?r Augenheilkunde     Volume:  227     ISSN:  1439-3999     ISO Abbreviation:  Klin Monbl Augenheilkd     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-21     Completed Date:  2010-05-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0014133     Medline TA:  Klin Monbl Augenheilkd     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  257-61     Citation Subset:  IM    
Copyright Information:
Copyright Georg Thieme Verlag KG Stuttgart . New York.
Affiliation:
Department of Ophthalmology, Inselspital, University Hospital, Bern, Switzerland. christoph.tappeiner@insel.ch
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MeSH Terms
Descriptor/Qualifier:
Acetamides / administration & dosage*
Aged
Anti-Bacterial Agents / administration & dosage
Anti-Infective Agents / administration & dosage
Drug Combinations
Endophthalmitis / drug therapy*,  etiology*,  prevention & control
Female
Humans
Male
Ophthalmologic Surgical Procedures / adverse effects*
Oxazolidinones / administration & dosage*
Retrospective Studies
Thienamycins / administration & dosage*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Acetamides; 0/Anti-Bacterial Agents; 0/Anti-Infective Agents; 0/Drug Combinations; 0/Oxazolidinones; 0/Thienamycins; 165800-03-3/linezolid; 96036-03-2/meropenem

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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