Pharmacists' Interventions in the Infection Control Team Reduce Prophylactic Intravenous Antibiotics in Cataract Surgery

Postoperative complications in cataract surgery are associated with an unfavorable prognosis, resulting in poor visual acuity. However, the use of intravenous antibiotics for the prevention of endophthalmitis in ophthalmic surgery has not been established in the current guidelines. Likewise, there are no clear criteria set for the use of prophylactic intravenous antibiotics in our institution. For this reason, the infection control pharmacists and the infection control team (ICT) worked collaboratively to investigate whether antibiotics were properly used, and we intervened to prevent the use of intravenous antibiotics in low risk patients. To clarify the effectiveness of such intervention, we retrospectively reviewed the medical records of patients who received cataract surgery for the 8 months before and after the implementation. The incidence rate of postoperative endophthalmitis, medical expenses, antimicrobial use density (AUD), and the number of anaphylactic shocks were assessed. The incidence rate of endophthalmitis after cataract surgery was evaluated by comparing the group of 853 pre-intervened patients and the group of 996 post-intervened patients. As a result, there was no significant difference in the incidence rate of postoperative endophthalmitis between the two groups. Furthermore, medical expenses and AUD were reduced after the intervention, and no anaphylactic shock occurred during the study period. The present study indicated that the incidence rate of endophthalmitis after cataract surgery did not increase without the prophylactic administration of intravenous antibiotics. Moreover, we contributed to the rational use of antibiotics by cooperating with ICT.