Abstract
IntroductionThe intravitreal injection of antibiotics remains the mainstay of therapy for postoperative endophthalmitis. Bacterial resistance, however, is still a pitfall in achieving an adequate response to treatment. Quinupristin/dalfopristin might be a feasible therapeutic option in these cases.Case presentationA 55-year-old Hispanic man had endophthalmitis secondary to Staphylococcus aureus in his right eye and was treated with intravitreal 0.4 mg/0.1 ml quinupristin/dalfopristin injection. Inflammation and pain remission were observed at four days after injection. The final best-corrected visual acuity was 20/40.ConclusionAlthough vancomycin remains the first-line intravitreal antibiotic therapy against infectious endophthalmitis caused by Gram-positive bacteria, quinupristin/dalfopristin exhibits similar efficacy and is theoretically more active against vancomycin-resistant strains, with no apparent retinal toxicity.
Highlights
The intravitreal injection of antibiotics remains the mainstay of therapy for postoperative endophthalmitis
Conclusion: vancomycin remains the first-line intravitreal antibiotic therapy against infectious endophthalmitis caused by Gram-positive bacteria, quinupristin/dalfopristin exhibits similar efficacy and is theoretically more active against vancomycin-resistant strains, with no apparent retinal toxicity
To the best of our knowledge, no reports of ocular toxicity exist [6]. Given this excellent anti-staphylococcal profile, the absence of ocular toxicity reports, the prolonged antibacterial effects, and the fact that no vancomycin was available at the time, we decided to treat the patient with the antibiotic combination described
Summary
Q/D showed a positive outcome in this case of infectious postoperative endophthalmitis caused by Gram-positive bacteria. To the best of our knowledge, this is the first report on the use of intravitreal quinupristin/dalfopristin in infectious Staphylococcus endophthalmitis. Patient’s perspective I write the following to provide assistance to the case report written about my operation. I arrived at the hospital with severe eye pain and completely blurred vision in my right eye a few days after my cataract surgery. I was told that one of the specific antibiotics for this type of infection was not available, but that a nonapproved one could be of benefit, so I agreed to be treated with the non-approved antibiotic via eye injection, in combination with other drugs as well as a vitrectomy surgery, which was performed subsequently. I still see some little dots, but my vision seems okay
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