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Surgeon urges colleagues to audit 'homemade intracameral antibiotics'
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BARCELONA — The results of an American Society of Cataract and Refractive Surgery survey in which participants noted that they have safety concerns with "homemade intracameral antibiotics" prompted David Lockington, MD, and colleagues to investigate two local hospitals with different preparation protocols.
For the study, ophthalmic nurses from the two hospitals were asked to dilute the potassium chloride (as a study surrogate for cefuroxime) and draw up 1 mg in 0.1 mL using their protocol and then again using the other hospital's protocol, Dr. Lockington of Glasgow, Scotland, said here at the European Society of Cataract and Refractive Surgeons meeting. From each group, 10 samples were obtained for each protocol. For the control arm of the study, chemists were also asked to use each protocol and obtain 10 samples, for a total of 30 samples for each protocol.
The data was analyzed by flame photometry.
The first protocol had a range of 0.62 mg to 1.77 mg, with a mean of 1.15 mg. The second protocol had a range of 0.52 mg to 7.25 mg, with a mean of 2.11 mg.
"The mean was significantly higher with protocol two," Dr. Lockington said.
"This study showed that mathematical accuracy of a protocol does not correspond with clinical accuracy and dosage," he said.
Dr. Lockington believes that the inaccuracy in protocol two was due to inadequate mixing in a 1 mL syringe, as "fluid does not mix in such a small space," he said. He recommended that such a small syringe not be used for mixing.
He concluded by saying it is worthwhile for colleagues who use homemade intracameral antibiotics to audit the protocol, assess the result and possibly reduce their concerns.