Topical azithromycin or ofloxacin for endophthalmitis

Abstract

Michael W Stewart, Michael L StewartDepartment of Ophthalmology, Mayo Clinic, Jacksonville, FL, USAThe recently published study by Romero-Aroca et al1 raises interesting questions regarding the effect of choice of topical antibiotic (azithromycin versus ofloxacin) on the incidence of endophthalmitis following intravitreal injections. However, important conclusions advanced by the authors deserve further discussion. First, the authors state that use of azithromycin leads to significantly fewer cases of post-injection endophthalmitis than does the use of ofloxacin. Their prospective series shows a lower endophthalmitis rate in eyes treated with azithromycin (two cases in 4045 injections, 0.049%) than in eyes treated with ofloxacin (five cases in 4151 injections, 0.12%). They calculate a relative risk of 2.37, and conclude that this was statistically significant (confidence interval 1.37–3.72; P < 0.001).View original paper by Romero-Aroca and colleagues.