Efficacy and Tolerance of the Wet Wipes with Poliheksanid for Eyelid Margin Hygiene as the Antibacterial Prophylaxis in Patients with Wet Form of Age-related Macular Degeneration Treated with anti-Vascular Endothelial Growth Factor Intravitreal Injection
str. 58 – 63
Autorzy: Magdalena Ulińska 1,2, Jacek P. Szaflik 1,2 , Ewa Strzemecka 1 , Katarzyna Piskorska-Małolepsza 3 , Magdalena Sikora 3 , Ewa Swoboda-Kopeć 4 , Maciej Osęka 5
1 Katedra i Klinika Okulistyki II Wydziału Lekarskiego Warszawskiego Uniwersytetu Medycznego
Kierownik: prof. dr hab. n. med. Jacek P. Szaflik
2 Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie
Dyrektor: prof. dr hab. n. med. Jacek P. Szaflik
3 Zakład Mikrobiologii Lekarskiej Szpitala Klinicznego Dzieciątka Jezus w Warszawie
Kierownik: dr n. przyr. Anna Sawicka-Grzelak
4 Katedra i Zakład Mikrobiologii Lekarskiej Warszawskiego Uniwersytetu Medycznego
Kierownik: prof. dr hab. n. med. Grażyna Młynarczyk
5 Ofta Sp. z o. o.
Summary: Anti-vascular endothelial growth factor intravitreal injections are currently the most common type of treatment in wet form of age-related macular degeneration. Exogenous endophthalmitis is very rare, but the most serious complication of such procedure. For many years, in prevention of bacterial endophthalmitis, wide spectrum antibiotics very used before and after injection. That type of prophylaxis is associated with possibility of bacterial drug-resistance.
The aim of the study was to check presence of bacterias species in conjunctival sac and to compare changes in bacteria presence in two groups of patients: 1 – using two times daily poliheksanid in wet wipes for 5 days before injection, and 2 – using fluoroquinolone in drops 3 times every 15 minutes one hour before and 4 times daily for 3 days after injection. Patients were additionally asked about tolerance of specimens they used.
Four samples (3 from the treated eye and 1 from the fellow eye) for microbiological cultures were taken in every patient undergoing intravitreal injections. The samples were incubated and the results were analyzed in two mentioned groups, taking into consideration changes in presence of bacteria.
Positive cultures were observed in both groups with similar percentage of existence. Changes of bacterial flora were observed, both from negative to positive and negative to positive cultures. Both type of antibacterial prophylaxis was well tolerated.
In conclusion, poliheksanid in wet wipes administered for 5 days two times daily before injection is a successful, well tolerated and comparable to quinolone usage, method of bacterias eradication in patients treated with anti-vascular endothelial growth factor intravitreal injections.