Page 123 - HPP ANTIMICROBIAL GUIDELINE 2018
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Suggested Treatment
Infection/ Condition Comments
Preferred Alternative
Post-operative Bacterial Intravitreal antibiotic injections Intravitreal antibiotic injections: Systemic antibiotics are indicated in
Endophthalmitis Vancomycin 1-2mg in 0.1ml Vancomycin 1-2mg in 0.1ml severe, virulent endophthalmitis
Repeat intravitreal antibiotics after
PLUS PLUS 48 to 72 hours if indicated
Ceftazidime 2mg in 0.1ml Amikacin 0.4mg in 0.1ml
*Prepared ready to use
extemporaneously by injectable forms
Topical treatment-options *Ceftazidime 5% eye drop,
*Vancomycin 5% eye drop,
*Gentamycin 1.4% eye drop
Moxifloxacin 0.5% eye drop
Levofloxacin 0.5% eye drop
(monotherapy or combination)
Systemic treatment Ciprofloxacin 750mg PO q12h for Moxifloxacin 400mg PO q24h for 10
10 days days (caution in children)
For culture negative cases add: OR
Clarithromycin 250-500mg PO q12h Vancomycin and ceftazidime IV
for 7-14 days
Post-operative Fungal Intravitreal Amphotericin B 0.005mg **Intravitreal miconazole (0.01mg in Intravitreal and Systemic therapy are
Endophthalmitis in 0.1ml 0.1ml) indicated in all cases
PLUS OR **Requires DG approval
Fluconazole 200mg PO q24h for 6 **Intravitreal voriconazole 50ug-
weeks (minimum) 100ug/0.1mls
** Voriconazole 200mg PO q12h
HPP AMG Ocular Infections 56
