녹내장 수술에 사용하는 예방적 항생제: 단일기관 경험
Use of Prophylactic Antibiotics in Glaucoma Surgery: A Single Center’s Experience
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목적: 녹내장 수술에서 예방적 항생제의 사용과 안내염의 발생에 대하여 알아보았다. 대상과 방법: 2008년 3월부터 2010년 2월까지 한 술자에 의해 수술을 받고 6개월 이상 추적 관찰된 총 136안을 후향적으로 조사하였다(방수유출장치삽입술 95안, 섬유주절제술 41안). 결과: 정맥내 항생제는 3세대 cephalosporin (10안), 4-fluoroquinolone (54안), 2세대 cephalosphorin (72안)을 사용하였다. 경구용항생제는 3세대 cephalosporin (125안), 4-fluoroquinolone (1안)이 사용되었고, 10안에서는 수술 후 경구용 항생제를 사용하지 않았다. 전신적 항생제의 총 사용 기간이 6일 이상인 경우는 14안, 4-5일은 115안, 3일 이하는 8안이었다. 4-Fluoroquinolone의 경우 6안,cephalosphorin의 경우 3안에서 피부병변, 오심 등의 부작용이 나타났고 경과 관찰 기간 동안 안내염은 1예도 관찰되지 않았다. 결론: 녹내장 수술 시 다양한 예방적 항생제가 사용됐고 사용 기간도 상이하였으나 술 후 6개월간의 관찰 기간 동안 안내염은 발생하지 않았다.
Abstract
Purpose: To evaluate the use of prophylactic antibiotics in glaucoma surgery and the prevalence of postoperative endophthalmitis. Methods: Retrospective medical record review was performed on 136 eyes which underwent glaucoma operation by one surgeon from March 2008 to February 2010 and were followed at least till 6 months postoperatively (glaucoma drainage device implantation; 95 eyes, trabeculectomy; 41 eyes). Results: For intravenous antibiotics injection, 10 eyes used 3rd generation cephalosporin, 54 eyes used 4-fluoroquinolone,72 eyes used 2nd generation cephalosporin. For oral antibiotics, 125 eyes used 3rd generation cephalosporin, 1 case used 4-fluoroquinolone, and other 10 cases did not use oral antibiotics after the surgery. Total period of systemic antibiotics use showed various distributions with 14 eyes more than 5 days, 115 eyes 4-5 days, and 8 cases less than 4 days. Six eye which used 4-fluoroquinolone and 3 eyes which used cephalosporin showed side effect such as skin lesion and nausea. There has been no single occurrence of endophthalmitis. Conclusions: Various kinds of prophylactic antibiotics were used for glaucoma surgery and the period of antibiotics use was different among patients. However, there has been no single occurrence of endophthalmitis till 6 months postoperative follow up.
참고문헌 (21)
- Armaly MF, "Lessons to be learned from the Collaborative Glaucoma Study", Surv Ophthalmol, 25, pp.139~144 (1980)
- Lundberg L, "Ocular hypertension. A prospective twenty-year follow-up study", Acta Ophthalmol, 65, pp.705~708 (1987)
- Grant WM, "Why do some people go blind from glaucoma?", Ophthalmology, 89, pp.991~998 (1982)
- Seo BR, "Treatment of infectious endophthalmitis", J Korean Ophthalmol Soc, 32, pp.561~568 (1991)
- Brod RD, "Advances in the diagnosis and treatment of infectious endotphthalmitis", Curr Opin Ophthalmol, 2, pp.306~314 (1991)
- Kattan HM, "Nosocomial endophthalmitis survey. Current incidence of infection after intraocular surgery", Ophthalmology, 98, pp.227~238 (1991)
- Goldstein MH, "Emerging fluoroquinolone resistance in bacterial keratitis: a 5-year review", Ophthalmology, 106, pp.1313~1318 (1999)
- Mather R, "Fourth generation fluoroquinolones: new weapons in the arsenal of ophthalmic antibiotics", Am J Ophthalmol, 133, pp.463~466 (2002)
- Bohigian GM, "Factors associated with a poor visual result in endophthalmitis", Am J Ophthalmol, 101, pp.332~341 (1986)
- Ciulla TA, "Bacterial endophthalmitis prophylaxis for cataract surgery: an evidence-based update", Ophthalmology, 109, pp.13~24 (2002)
- Ou JI, "Endophthalmitis prophylaxis", Ophthalmol Clin North Am, 19, pp.449~456 (2006)
- Mandelbaum S, "Endophthalmitis associated with filtering blebs", Int Ophthalmol Clin, 27, pp.107~111 (1987)
- Wolner B, "Late bleb-related endophthalmitis after trabeculectomy with adjunctive 5-fluorouracil", Ophthalmology, 98, pp.1053~1060 (1991)
- Gedde SJ, "Late endophthalmitis associated with glaucoma drainage implants", Ophthalmology, 108, pp.1323~1327 (2001)
- AI-Torbak AA, "Endophthalmitis associated with the Ahmed glaucoma valve implant", Br J Ophthalmol, 89, pp.454~458 (2005)
- DeBry PW, "Incidence of late-onset bleb-related complications following trabeculectomy with mitomycin", Arch Ophthalmol, 120, pp.297~300 (2002)
- Lehmann OJ, "Risk factors for development of post-trabeculectomy endophthalmitis", Br J Ophthalmol, 84, pp.1349~1353 (2000)
- Jampel HD, "Risk factors for late-onset infection following glaucoma filtration surgery", Arch Ophthalmol, 119, pp.1001~1008 (2001)
- Wykoff CC, "Nosocomial acute-onset postoperative endophthalmitis at a university teaching hospital( 2002-2009)", Am J Ophthalmol, 150, pp.392~398 (2010)
- Lipsky BA, "Fluoroquinolone toxicity profiles: a review focusing on newer agents", Clin Infect Dis, 28, pp.352~364 (1999)
- Cunha BA, "Antibiotic side effects", Med Clin North Am, 85, pp.149~185 (2001)