Antibiotics do not lower Avastin infection risk

Prophylactic antibiotics do not lower the incidence of endophthalmitis in patients receiving Avastin (bevacizumab) injections, according to results of a study published in the February 2008 issue of Spektrum der Augenheilkunde.

Carsten H. Meyer, MD of the Augenklinik at Bonn University, Germany and colleagues conducted a retrospective study of two groups of patients receiving 1.25 mg/0.05 ml Avastin after an incubation of 5% povidone-iodine for 60 seconds in the conjunctival fornix. The first set of subjects (Group A; n=984) underwent the injection as an outpatient procedure and received no prophylactic antibiotics after the injection. In the second set (Group B; n=860), patients were admitted to hospital for one day and received three days of topical antibiotics following the injection.

The subjects of Group A had a zero incidence of post-injection endophthalmitis; two patients developed intraocular uveitis, which was treated successfully with topical steroids. In Group B, the two cases of post-injection endophthalmitis that developed after five days were treated with vitrectomy.

The researchers concluded that administration of prophylactic antibiotics was unable to eliminate endophthalmitis in these cases; when considering this factor, it is irrelevant whether the injection of Avastin is administered on an inpatient or outpatient basis.