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Article
August 1996

The Endophthalmitis Vitrectomy Study-Reply

Author Affiliations

Boston, Mass
Pittsburgh, Pa

Arch Ophthalmol. 1996;114(8):1026-1027. doi:10.1001/archopht.1996.01100140233032
Abstract

In reply  Drs Baker and Durand, and Drs Haimann, Weiss, and Miller raise important issues about systemic antibiotics in the treatment of postoperative endophthalmitis. They suggest that if the EVS had used vancomycin systemically, the study might have found that systemic antibiotics were of value.The EVS investigators and infectious disease consultants carefully evaluated the antibiotic choices made during the planning phase and reevaluated them during the ongoing clinical trial.1 Vancomycin and amikacin were the intravitreal antibiotics, and ceftazidime and amikacin were employed systemically, except that oral ciprofloxacin was used for patients who might be allergic to ceftazidime (a penicillinlike drug).Vancomycin was chosen as 1 of the intravitreal drugs because of the high level of susceptibility of gram-positive organisms. However, it was for good reason that the drug was not chosen for systemic administration. Multiple publications have shown penetration of vancomycin into the vitreous cavity after systemic administration

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