Bari, AafreenChawla, RohanMishra, DeepanshiDas, UjjwalkumarHasan, NasiqSatpathy, GitaVelpandian, TAzad, Shorya VVenkatesh, PradeepVohra, RajpalKumar, Atul2023-08-252023-08-252022-05Bari Aafreen, Chawla Rohan, Mishra Deepanshi, Das Ujjwalkumar, Hasan Nasiq, Satpathy Gita, Velpandian T, Azad Shorya V, Venkatesh Pradeep, Vohra Rajpal, Kumar Atul. Real-life comparison of three intravitreal antibiotic drug regimens in endophthalmitis. Indian Journal of Ophthalmology. 2022 May; 70(5): 1696-17001998-36890301-4738http://imsear.searo.who.int/handle/123456789/224305Purpose: Real?life comparison of three intravitreal drug regimens used in cases of endophthalmitis at a tertiary care center in India. Methods: In this prospective, comparative study, patients of bacterial endophthalmitis were grouped according to intravitreal antibiotic drug regimens into Group 1 (ceftazidime and vancomycin), Group 2 (piperacillin + tazobactam and vancomycin), and Group 3 (imipenem and vancomycin). Forty?eight hours after injection nonresponding/worsening patients underwent vitrectomy. Vitreous samples were subjected to microbiological and pharmacokinetic tests. Results: A total of 64 patients were included and divided into Group 1: 29, Group 2: 20, and Group 3: 15 cases. Also, 75% of patients were post?surgical endophthalmitis, whereas 25% were post?traumatic. Improvement in vision (V90?0) and vision at 3 months (V90) were comparable between the three groups. Visual recovery was poorer in post?traumatic cases. In post?surgical cases, visual recovery was poorer in those presenting beyond 72 h of onset of symptoms (P = 0.0002). Polymerase chain reaction (PCR) positivity (66%) was higher than BACTECTM (33%) and culture (14%). Antibiotic resistance was comparable amongst the three groups. Most patients (62/64) further underwent vitrectomy. Ceftazidime and vancomycin achieved vitreous concentrations more than the minimum inhibitory concentration (MIC) at 48 h after the first injection. Conclusion: The choice of antibiotics did not affect the rate of vitrectomy and final vision in a real?life scenario. Ceftazidime and vancomycin can still be used as first?line intravitreal antibiotics owing to their comparable microbial sensitivity profile and adequate ocular bioavailabilityCeftazidimeendophthalmitisimipenempiperacillin/tazobactamvancomycinJournal ArticleIndiaDr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, IndiaOcular Microbiology, Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, IndiaOcular Pharmacology, Dr RP Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India