{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T22:37:02Z","timestamp":1790462222713,"version":"4.1.0"},"reference-count":46,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T00:00:00Z","timestamp":1665100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Fund for Regional Development of Bourgogne Franche Comt\u00e9 (FEDER-FSE Bourgogne 2014\u20132020)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Background: The dramatic increase in intravitreal injections (IVTs) has been accompanied by a greater need for safer procedures. The ongoing debate about topical antibiotic prophylaxis after IVTs emphasizes the importance of large-scale studies. We aimed to study the role of topical antibiotic prophylaxis in reducing the risk of acute endophthalmitis after IVTs. Methods: Population-based cohort study, in France, from 2009 to 2018, including all French patients receiving IVTs of corticosteroids or anti-VEGF agents. Results: A total of 5,291,420 IVTs were performed on 605,434 patients. The rate of topical antibiotic prophylaxis after IVTs progressively decreased during the study period, with a sharp drop in 2014 (from 84.6% in 2009 to 27.4% in 2018). Acute endophthalmitis occurred in 1274 cases (incidence rate = 0.0241%). Although antibiotic prophylaxis did not alter the risk of endophthalmitis (p = 0.06), univariate analysis showed an increased risk after fluoroquinolone and aminoglycoside prophylaxis. This increased risk was not found in multivariate analysis. However, we observed an increased risk related to the use of fixed combinations of fluoroquinolones and aminoglycosides with corticosteroids (IRR = 1.89; 95% CI = 1.57\u20132.27%, antibiotics combined with corticosteroids). Conclusion: These results are consistent with the literature. Endophthalmitis rates after IVTs did not decrease with topical antibiotic prophylaxis. The use of a combination of antibiotics and corticosteroids doubles the risk of endophthalmitis and should be avoided. Avoiding antibiotic prophylaxis would reduce the costs and the potential risks of antibiotic resistance.<\/jats:p>","DOI":"10.3390\/pharmaceutics14102133","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T01:21:07Z","timestamp":1665364867000},"page":"2133","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Topical Antibiotic Prophylaxis and Intravitreal Injections: Impact on the Incidence of Acute Endophthalmitis\u2014A Nationwide Study in France from 2009 to 2018"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4976-9876","authenticated-orcid":false,"given":"Florian","family":"Baudin","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Hospital, 21000 Dijon, France"},{"name":"EA7460, PEC2, Cerebral and Cardiovascular Epidemiology, and Physiopathology, 21000 Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Benzenine","sequence":"additional","affiliation":[{"name":"Biostatistics and Bioinformatics (DIM), University Hospital, 21079 Dijon, France"},{"name":"Biostatistics and Bioinformatics (DIM), University Hospital, Bourgogne Franche-Comt\u00e9 University, BP 77908, 21079 Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0134-1248","authenticated-orcid":false,"given":"Anne-Sophie","family":"Mariet","sequence":"additional","affiliation":[{"name":"Biostatistics and Bioinformatics (DIM), University Hospital, 21079 Dijon, France"},{"name":"Biostatistics and Bioinformatics (DIM), University Hospital, Bourgogne Franche-Comt\u00e9 University, BP 77908, 21079 Dijon, France"},{"name":"INSERM, CIC 1432, 21000 Dijon, France"},{"name":"Clinical Epidemiology, Clinical Trials Unit, Clinical Investigation Center, Dijon University Hospital, 21000 Dijon, France"},{"name":"Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Universit\u00e9 Paris-Saclay, 94807 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4002-7414","authenticated-orcid":false,"given":"In\u00e8s Ben","family":"Ghezala","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital, 21000 Dijon, France"},{"name":"EA7460, PEC2, Cerebral and Cardiovascular Epidemiology, and Physiopathology, 21000 Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7265-931X","authenticated-orcid":false,"given":"Alain M.","family":"Bron","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital, 21000 Dijon, France"},{"name":"Eye and Nutrition Research Group, Bourgogne Franche-Comt\u00e9 University, 21000 Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Daien","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital, 34295 Montpellier, France"},{"name":"Inserm U1061, University of Montpellier, 34000 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9688-4845","authenticated-orcid":false,"given":"Pierre-Henry","family":"Gabrielle","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital, 21000 Dijon, France"},{"name":"Eye and Nutrition Research Group, Bourgogne Franche-Comt\u00e9 University, 21000 Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5134-9411","authenticated-orcid":false,"given":"Catherine","family":"Quantin","sequence":"additional","affiliation":[{"name":"Biostatistics and Bioinformatics (DIM), University Hospital, 21079 Dijon, France"},{"name":"Biostatistics and Bioinformatics (DIM), University Hospital, Bourgogne Franche-Comt\u00e9 University, BP 77908, 21079 Dijon, France"},{"name":"INSERM, CIC 1432, 21000 Dijon, France"},{"name":"Clinical Epidemiology, Clinical Trials Unit, Clinical Investigation Center, Dijon University Hospital, 21000 Dijon, France"},{"name":"Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Universit\u00e9 Paris-Saclay, 94807 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Creuzot-Garcher","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital, 21000 Dijon, France"},{"name":"Eye and Nutrition Research Group, Bourgogne Franche-Comt\u00e9 University, 21000 Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1001\/jamaophthalmol.2018.3939","article-title":"Association of Acute Endophthalmitis with Intravitreal Injections of Corticosteroids or Anti\u2013Vascular Growth Factor Agents in a Nationwide Study in France","volume":"136","author":"Baudin","year":"2018","journal-title":"JAMA Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/S0161-6420(01)00899-5","article-title":"Bacterial endophthalmitis prophylaxis for cataract surgery: An evidence-based update","volume":"109","author":"Ciulla","year":"2002","journal-title":"Ophthalmology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1001\/archophthalmol.2012.227","article-title":"Update on Risk of Endophthalmitis After Intravitreal Drug Injections and Potential 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