Abstract :
PURPOE: To determine whether the routine ue of vancomycin prophylaxi in elective cataract urgery promote emerging reitance and provide effective protection againt pot-operative endophthalmiti.
METHOD: Critical review of the current cientific and clinical literature wa undertaken including appropriate tatitical analye of publihed data.
REULT: Public health concern for emergent vancomycin-reitant life-threatening “uper bug” are legitimate. Evaluation of the rik factor that are known to promote emerging vancomycin reitance (ick patient, hopital intenive care unit etting, methicillin-reitant taphylococcu aureu (MRA) clonal infection, prolonged ytemic therapy, ub-therapeutic doing, indwelling intravacular and drainage catheter, total kilogram uage and agricultural ue) ugget that ophthalmic uage in routine cataract urgery i unlikely to be a ignificant factor in promoting emerging worldwide reitance. Clinical and cientific tudie purporting to prove the value of vancomycin prophylaxi in cataract urgery contain ubtantial biae and deign flaw that eriouly undermine their validity. Iue of potential intraocular toxicity, increaed cot, abence of medical-legal protection, and compliance with current Center for Dieae Control and Prevention (CDC) and American Academy of Ophthalmology guideline (in hopital) mitigate againt thi practice.
CONCLUION: Ophthalmologit who ue vancomycin prophylaxi in routine cataract urgery are neither the villain nor heroe according to my interpretation of the currently available cientific data. Peronal concience and an ongoing critical review of the literature hould guide each ophthalmologit’ choice in thi controvery.
