Neobook — clinical reference

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S05.4-6 + (Y43.99), H44.0

DESCRIPTION

Infection of the ocular cavity is an emergency as it can cause blindness.
This may occur secondary to bacteraemia (endogenous infection) or, more commonly, after penetrating ocular injury or surgery.
In patients with endogenous endophthalmitis blood cultures should be done and the source of infection identified and treated.
In patients with endophthalmitis after penetrating injury/surgery culture should be done on specimens of aqueous or vitreous humour.

MEDICINE TREATMENT

Refer immediately to an ophthalmologist.

Endogenous endophthalmitis

Specialist initiated, vitrectomy often required:

Ceftriaxone, IV, 2 g daily for 7 days.

Adjust antibiotics according to culture and sensitivity results.

AND

Ceftazidime, intravitreal, 2.25 mg.

LoE:IIIbⁱⁱⁱ

AND

Vancomycin, intravitreal, 1 mg.
- Administer antibiotics using separate tuberculin syringes.
- Antibiotic doses may be repeated after 48 hours depending on culture results or clinical response.

LoE:IIIb^iv, LoE:IIIb^v

Post-surgical endophthalmitis

Specialist initiated, vitrectomy often required:

Ceftazidime, intravitreal, 2.25 mg.

AND

Vancomycin, intravitreal, 1 mg.
- Administer antibiotics using separate tuberculin syringes.
- Antibiotic doses may be repeated after 48 hours depending on culture results or clinical response.

In addition, if there is soft tissue involvement or as prophylaxis after a penetrating eye injury:

Ciprofloxacin, oral, 750 mg 12 hourly for 7 days.

LoE:IIIb^vi

Click here to access the pdf.

Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2020-2024_Version 1.0_30 September 2024

Chapter 18 Eye Disorders_18.2 Endophthalmitis, Bacterial

Endophthalmitis, Bacterial

Drugs mentioned

ICD-10 codes