Posters

The role of oral linezolid in the management of postoperative endophthalmitis

Poster Details

First Author: O.Makhzoum UK

Co Author(s):    I. Elaraoud   W. Andreatta   M. Hero                       

Abstract Details



Purpose:

To share our positive eight-year experience of using oral linezolid as an adjunctive oral antibiotic cover in acute postoperative endophthalmitis cases.

Setting:

Tertiary ophthalmic referral centre.

Methods:

Case note consecutive retrospective review.

Results:

8 patients were identified, 6 post cataract surgery and 2 post-intravitreal injections. All patients had urgent vitreous biopsy and intravitreal injection of ceftazidime and vancomycin as by local protocol. Oral linezolid 600mg twice a day was commenced on the same day for a duration of 5 days. As linezolid mainly affective against gram positive bacteria, 2 patients were discontinued as their gram staining of the vitreous sample showed gram negative bacteria. Presenting visual acuity varied between 6/24 to hand movement. Patients had an average visual improvement of more than 10 letters at 2 months with one patient improved from 6/60 to 6/6.

Conclusions:

postoperative endophthalmitis is a serious condition that can lead to blindness if not treated promptly, the gold standard for its treatment is immediate intravitreal antibiotics injections covering a wide spectrum organism usually a combination of vancomycin to target gram positive and ceftazidime or amikacin targeting the gram negative bacteria. Linezolid is a new generation oxazolidinone antibiotics that is extremely effective against gram positive bacteria. The advantage of using linezolid in endophthalmitis is that it has a hundred percent bioavailability in the vitreous when it is given systemically making it an ideal supplementary treatment to keep a persistent therapeutic levels in the vitreous cavity and it is known that it is affective even in vancomycin resistant gram-positive bacteria. No adverse effect to the oral linezolid was documented in our cohort.

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