Impact of discontinuation of cephazolin prophylaxis on the incidence of postoperative adverse events in cataract surgery
Abstract Background Cataract surgeries are increasing annually, making appropriate medical management essential. The routine use of systemic antimicrobial agents for preventing surgical site infections lacks strong evidence and may increase the risk of drug-resistant bacteria and adverse events. Thi...
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BMC
2025-01-01
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| Series: | Journal of Pharmaceutical Health Care and Sciences |
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| Online Access: | https://doi.org/10.1186/s40780-025-00412-x |
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| author | Kazutaka Uchida Keita Takahama Kenshiro Higashi Yuki Kusano Koki Matsumoto Yoshihiro Nakagawa Kazutaka Oda |
| author_facet | Kazutaka Uchida Keita Takahama Kenshiro Higashi Yuki Kusano Koki Matsumoto Yoshihiro Nakagawa Kazutaka Oda |
| author_sort | Kazutaka Uchida |
| collection | DOAJ |
| description | Abstract Background Cataract surgeries are increasing annually, making appropriate medical management essential. The routine use of systemic antimicrobial agents for preventing surgical site infections lacks strong evidence and may increase the risk of drug-resistant bacteria and adverse events. This study examined the impact of discontinuing cefazolin (CEZ) administration during the perioperative period of cataract surgery on the incidence of postoperative adverse events and medical costs. Methods Inpatient cataract surgery patients were divided into two groups: the CEZ-use group (April 2021 to March 2022) and the non-CEZ-use group (April 2022 to March 2023). The primary endpoints were the incidence of adverse events and medical costs, while the secondary endpoint was the incidence of endophthalmitis. Results A total of 265 patients were in the CEZ group, and 316 were in the non-CEZ group. Six postoperative adverse events (2.3%, 95% confidence interval: 0.8–4.9) occurred in the CEZ group, with an estimated 230 patients (80–490 from the 95% confidence interval) expected to experience adverse events per 10,000 patients using CEZ. The non-CEZ group had no adverse events and reduced drug costs by approximately 46,000 yen. Insurance claim amounts were also reduced. No cases of early postoperative endophthalmitis were observed in either group. Conclusions Discontinuation of CEZ prophylaxis during the perioperative period of cataract surgery effectively reduced the risk of adverse events. Medical for the period after discontinuing CEZ did not increase. Trial registration Retrospectively registered. |
| format | Article |
| id | doaj-art-02242c5322d748ef8c8eb41f5ecde850 |
| institution | Kabale University |
| issn | 2055-0294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Pharmaceutical Health Care and Sciences |
| spelling | doaj-art-02242c5322d748ef8c8eb41f5ecde8502025-02-02T12:34:50ZengBMCJournal of Pharmaceutical Health Care and Sciences2055-02942025-01-011111510.1186/s40780-025-00412-xImpact of discontinuation of cephazolin prophylaxis on the incidence of postoperative adverse events in cataract surgeryKazutaka Uchida0Keita Takahama1Kenshiro Higashi2Yuki Kusano3Koki Matsumoto4Yoshihiro Nakagawa5Kazutaka Oda6Department of Pharmacy, Kumamoto Shinto General HospitalDepartment of Pharmacy, Kumamoto Shinto General HospitalDepartment of Pharmacy, Kumamoto Shinto General HospitalDepartment of Ophthalmology, Kumamoto Shinto General HospitalDepartment of Ophthalmology, Kumamoto Shinto General HospitalDepartment of Pharmacy, Kumamoto Shinto General HospitalDepartment of Pharmacy, Kumamoto University HospitalAbstract Background Cataract surgeries are increasing annually, making appropriate medical management essential. The routine use of systemic antimicrobial agents for preventing surgical site infections lacks strong evidence and may increase the risk of drug-resistant bacteria and adverse events. This study examined the impact of discontinuing cefazolin (CEZ) administration during the perioperative period of cataract surgery on the incidence of postoperative adverse events and medical costs. Methods Inpatient cataract surgery patients were divided into two groups: the CEZ-use group (April 2021 to March 2022) and the non-CEZ-use group (April 2022 to March 2023). The primary endpoints were the incidence of adverse events and medical costs, while the secondary endpoint was the incidence of endophthalmitis. Results A total of 265 patients were in the CEZ group, and 316 were in the non-CEZ group. Six postoperative adverse events (2.3%, 95% confidence interval: 0.8–4.9) occurred in the CEZ group, with an estimated 230 patients (80–490 from the 95% confidence interval) expected to experience adverse events per 10,000 patients using CEZ. The non-CEZ group had no adverse events and reduced drug costs by approximately 46,000 yen. Insurance claim amounts were also reduced. No cases of early postoperative endophthalmitis were observed in either group. Conclusions Discontinuation of CEZ prophylaxis during the perioperative period of cataract surgery effectively reduced the risk of adverse events. Medical for the period after discontinuing CEZ did not increase. Trial registration Retrospectively registered.https://doi.org/10.1186/s40780-025-00412-xCataract surgeryCefazolinSurgical site infectionsAdverse events |
| spellingShingle | Kazutaka Uchida Keita Takahama Kenshiro Higashi Yuki Kusano Koki Matsumoto Yoshihiro Nakagawa Kazutaka Oda Impact of discontinuation of cephazolin prophylaxis on the incidence of postoperative adverse events in cataract surgery Journal of Pharmaceutical Health Care and Sciences Cataract surgery Cefazolin Surgical site infections Adverse events |
| title | Impact of discontinuation of cephazolin prophylaxis on the incidence of postoperative adverse events in cataract surgery |
| title_full | Impact of discontinuation of cephazolin prophylaxis on the incidence of postoperative adverse events in cataract surgery |
| title_fullStr | Impact of discontinuation of cephazolin prophylaxis on the incidence of postoperative adverse events in cataract surgery |
| title_full_unstemmed | Impact of discontinuation of cephazolin prophylaxis on the incidence of postoperative adverse events in cataract surgery |
| title_short | Impact of discontinuation of cephazolin prophylaxis on the incidence of postoperative adverse events in cataract surgery |
| title_sort | impact of discontinuation of cephazolin prophylaxis on the incidence of postoperative adverse events in cataract surgery |
| topic | Cataract surgery Cefazolin Surgical site infections Adverse events |
| url | https://doi.org/10.1186/s40780-025-00412-x |
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