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February 2003

Antibiotic Prophylaxis in Clear Corneal Cataract Surgery

Arch Ophthalmol. 2003;121(2):296. doi:10.1001/archopht.121.2.296-a

We read with great interest the article by Cosar et al1 on clear corneal wound infection after phacoemulsification. We have also treated 4 patients with similar infections. However, we disagree with the last statement in the article, "Our data support the use of typical [sic] trimethoprim-polymyxin B sulfate and/or bacitracin for perioperative antibiotic prophylaxis."1(p1759) Only 4 of 7 patients in this study had cultures positive for microorganisms. All 4 patients with positive cultures were sensitive to bacitracin, and only 3 of these 4 were sensitive to trimethoprim-polymyxin B sulfate. Trimethoprim-polymyxin B sulfate was not tested against Streptococcus pneumoniae. Typically, this antibiotic is not effective for streptococci, so it is not tested in automated systems. We do not know if the other 3 infections without positive cultures were susceptible.

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