Antimicrobial resistance in post-cataract endophthalmitis: a systematic review on resistance pattern and treatment outcomes.
Antimicrobial resistance in Post-Cataract Endophthalmitis is an escalating concern with marked geographic variation.
Antimicrobial resistance in post-cataract endophthalmitis: a systematic review on resistance pattern and treatment outcomes.
To systematically review the microbiological spectrum, antimicrobial resistance (antimicrobial resistance) patterns, management strategies, and outcomes in culture-positive endophthalmitis, a rare vision-threatening complication of cataract surgery increasingly challenged by resistance.
A comprehensive literature search was conducted in PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials from 1 January 1990 to 30 June 2025.
Six studies (five retrospective, one prospective) from Europe, Asia, and North America met inclusion criteria.
While vancomycin remained active against Gram-positive organisms, emerging resistance was reported in the United Kingdom.
Amikacin resistance correlated with poorer outcomes, whereas vancomycin or moxifloxacin resistance did not.
Systemic antibiotics and intravitreal corticosteroids showed no consistent benefit.
Antimicrobial resistance in Post-Cataract Endophthalmitis is an escalating concern with marked geographic variation.
Prompt intravitreal therapy remains the key determinant of prognosis, but empiric regimens must reflect local resistance trends, particularly for Gram-negative coverage.
Current evidence is limited by retrospective design and regional variability; multicentre prospective studies are needed to refine prophylaxis and treatment protocols, reducing visual and economic burden.