Abstract:Background: Postoperative endophthalmitis is a vision-threatening intraocular infection that requires prompt empirical antibiotic therapy to prevent irreversible damage. The selection of initial antibiotics is critical, especially in resource-constrained settings where microbiological confirmation may be delayed.
Materials and Methods: This retrospective observational study was conducted in the Department of Pharmacology, Maharajah’s Institute of Medical Sciences, Nellimarla, from March 2021 to February 2022. Data from 78 patients diagnosed with postoperative endophthalmitis were analyzed. Demographic variables, etiology, empirical antibiotic regimens used, culture results, and visual outcomes were recorded. Statistical analysis included chi-square and Fisher's exact tests, with significance set at p<0.05.
Results: The mean age of patients was 62.4±10.5 years, with 57.7% males. The most common cause was post-cataract surgery (53.8%). The predominant empirical therapy administered was vancomycin plus ceftazidime (46.2%), followed by vancomycin plus amikacin (30.8%). Culture positivity was observed in 50% of cases, with coagulase-negative Staphylococci (23.1%) being the most frequently isolated organism. Visual improvement was highest in patients receiving vancomycin plus ceftazidime (69.4%), compared to vancomycin plus amikacin (54.2%) and monotherapy (40.0%). Statistically significant differences were observed in visual outcome across antibiotic regimens (p = 0.038).
Conclusion: Vancomycin combined with ceftazidime emerged as the most effective empirical regimen for postoperative endophthalmitis, demonstrating superior visual outcomes and broad-spectrum coverage. These findings support its use as a first-line empirical choice, especially before culture results are available.
