Guidelines for intravitreal injections discourage need for topical antibiotics to prevent endophthalmitis

An expert panel that was convened to update guidelines for giving intravitreal injections makes clear that routine use of topical antibiotics before, during or after the procedure is not supported by evidence and is likely unnecessary. Stopping this practice, however, may be difficult for both patients and physicians to accept, if only to maintain the perceived added protection for the patient.Ten years ago, when the number of intravitreal injections given per year was minimal, a similar panel convened. Those consensus guidelines suggested that physicians “may consider using preinjection topical antibiotics,” with the caveats that limited data supported preinjection use of antibiotics and that antimicrobial resistance was possibly more likely to occur with the antibiotic treatment.