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November 1981

Endophthalmitis Therapy-Reply

Author Affiliations

New Orleans

Arch Ophthalmol. 1981;99(11):2055-2056. doi:10.1001/archopht.1981.03930020932027

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In Reply.  —In response to the letter by Drs Baum and Barza, it is imperative that a general misunderstanding of the article be initially cleared. The supposition that my systematic approach to the management of bacterial endophthalmitis consists primarily of a single intravitreal injection is grossly misrepresented. Such misunderstanding undoubtedly results from a previous general preoccupation in the microbiological basis for initial therapy. The article clearly describes a combination of factors including time of onset, predisposing cause, echographic findings, and initial Gram's stain to form a basis on which treatment is instituted. When this information is combined with recent inroads into intravitreal antibiotics and vitrectomy, a new method of management results.Staphylococcus aureus and, particularly, S epidermidis, if treated early, are generally amenable to noninvasive ocular therapy. When other organisms are present, however, the success rate in therapy is severely tested. It was my objective to present to the practitioner

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