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Small Case Series
Oct 2012

Quinupristin/Dalfopristin in Vancomycin-Resistant Staphylococcus aureus Endophthalmitis

Author Affiliations

Author Affiliations: Department of Ophthalmology, Mercy Medical Center, Rockville Centre, and Department of Ophthalmology, Hofstra University School of Medicine, Hempstead, New York.

Arch Ophthalmol. 2012;130(10):1323-1324. doi:10.1001/archophthalmol.2012.1504

Postoperative bacterial endophthalmitis is the most dreaded complication of any eye surgery. Once infection is suspected, prompt treatment by vitreous tap and biopsy or by vitrectomy and injection of intravitreal antibiotics is instituted prior to identifying the specific bacteria and its antibiotic sensitivities. Of the 70% of cases that were culture positive in the Endophthalmitis Vitrectomy Study (EVS), 94% were gram-positive organisms that were all sensitive to vancomycin.1 The recent Antibiotic Resistance Monitoring in Ocular micRorganisms 2009 study reported that 39% of Staphylococcus aureus isolates were resistant to methicillin, but all were still sensitive to vancomycin.2Several recent cases of endophthalmitis due to vancomycin-resistant S aureus and Enterococcus have also been reported.3-5Of the few antibiotics effective against vancomycin-resistant bacteria, only intravitreal quinupristin/dalfopristin has been reported previously in a single human eye.6In the current series, 2 additional cases are reported with successful treatment of vancomycin-resistant S aureus endophthalmitis with intravitreal quinupristin/dalfopristin.