Purpose. The recently increasing incidence of infection and colonization with vancomycin-resistant gram-positive organisms in U.S. hospitals represents a serious public health concern and has prompted the Centers for Disease Control (CDC) to issue guidelines for preventing the spread of vancomycin resistance. The ophthalmic use of topical vancomycin may be a potential contributor to the emergence of vancomycin-resistant strains. This study profiles the use of topical vancomycin at one tertiary care eye center and analyzes the indications and necessity for its use. Methods. We retrospectively reviewed the medical and microbiological records of all patients at the Bascom Palmer Eye Institute who were placed on topical vancomycin from 6/1/95 to 9/15/95. Results. Of 35 patients included in the study, 33 (94%) were placed on combination therapy of vancomycin with another topical antibiotic. In all cases, this was instituted empirically, prior to availability of culture results. From this population, 16 gram-negative isolates and 14 gram-positive isolates were cultured. Five patients had multiple-organism involvement, 6 patients were culture negative, and 6 patients were not cultured. All gram positive isolates were sensitive to ciprofloxacin and to cefazolin or cephalothin, as well as to vancomycin. Conclusions. In all patients for whom culture results would later become available, alternative initial empiric drug regimens not utilizing topical vancomycin would have been efficacious These results suggest that the practice of empiric use of topical vancomycin can be safely reduced or discontinued. We recommend more judicious utilization of this drug.
|Original language||English (US)|
|Journal||Investigative Ophthalmology and Visual Science|
|State||Published - Feb 15 1996|
ASJC Scopus subject areas
- Sensory Systems
- Cellular and Molecular Neuroscience