REVIEW   

Minerva Oftalmologica 2019 March;61(1):1-8

DOI: 10.23736/S0026-4903.18.01812-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Perspectives for the use of fosfomycin as an antibiotic for the therapy, preemptive therapy and the prevention of postoperative and postinjection endophthalmitis

Herbert HOF ¹ ✉, Daniela BERTSCH ¹, Alireza MIRSHAHI ²

¹ MVZ Labor Limbach, Heidelberg, Germany; ² Dardenne Klinik, Bonn, Germany

The causative agents of postoperative endophthalmitis are quite different, whereby Staphylococci are the most prevalent pathogens. Therefore, antibiotics with a broad spectrum of activity have to be applied for prevention or therapy. The possible role of fosfomycin for prevention as well as for treatment of perioperative ophthalmitis is discussed. The activities of fosfomycin and cefuroxime of common pathogens which are able to induce endophthlamitis were tested in vitro by standard methods. In comparison to the standard antibiotics, such as cephalosporins, quinolones and vancomycin, fosfomycin owns some advantages. Microbiological arguments vote for the use of this agent because of its broad spectrum of activity (including multiresistant Staphylococci), its long postantibiotic effect, its bactericidal activity and its synergistic action with many other antibiotics. Furthermore, the pharmacological properties recommend this antibiotic alone or in combination with other antibiotics for the use in ophthalmology: its low molecular weight and its low protein binding are the main reasons for good tissue penetration so that high intraocular concentrations after IV injection are found. In addition, it is well tolerated and allergic reactions are quite rare. Fosfomycin is, obviously, a candidate antibiotic to be used for therapy, preemptive therapy and the prevention of postoperative and postinjection endophthalmitis.

KEY WORDS: Fosfomycin; Endophthalmitis; Anti-infective agents