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A Journal on Ophthalmology
Minerva Oftalmologica 2015 June-December;57(2-4):17-22
The management of eye bacterial infections: not all the AAS are the same
Marangolo L., Verrecchia V., D’Andrea D.
Unità Operativa Chirurgia Vitreoretinica, Banca degli Occhi dell’Aquila, L’Aquila, Italia
Antibiotics are essential and prescribers must preserve their effectiveness over time. Not all bacterial infections require antibiotic therapy. The choice of the antibiotic is usually empirical or based on the knowledge of the most common organisms involved in eye infections, since antibiogram is usually not required. Prescribers should choose anti Gram positive agents in adults ocular surface infection, and antibiotics active on Haemophilus and Streptococcus in children. The spectrum of activity of antibiotics change over time due to the development of bacterial resistance. In 2009 the European Medicines Agency (EMA) and the European Centre for the Prevention and Control (ECDC) emphasized that the antibiotic resistance rate of the bacteria responsible for severe infections exceeded 25% in many European countries and 25,000 deaths in Europe each year are caused by infections caused by multiresistant germs. In recent decades in ophthalmology, fluoroquinolones have been widely used for the prophylactic purposes, resulting in a sharp increase in bacterial resistance, although their use should be restricted to less common dangerous bacteria. The rational use of antibiotics should follow few simple recommendations: avoid excessive and inappropriate prescription, follow probabilistic criteria, avoid routine use of antibiotics active on dangerous germs.