Antimicrobial guide to posterior segment infections

Abstract

Purpose: This review article is meant to serve as a reference guide and to assist the treating physician in making an appropriate selection and duration of an antimicrobial agent.

Methods: Literature review.

Results: Infections of the posterior segment require prompt medical or surgical therapy to reduce the risk of permanent vision loss. While numerous options exist to treat these infections, doses and alternative therapies, especially with contraindications for first-line therapy, are often elusive. Antimicrobial agents to treat posterior segment infections can be administered via various routes, including topical, intravitreal, intravenous, and oral.

Conclusions: Although there are many excellent review articles on the management of endophthalmitis, we take the opportunity in this review to comprehensively summarize the appropriate antimicrobial regimen of both common and rare infectious etiologies of the posterior segment, using evidence from clinical trials and large case series.

Keywords: Antihelminthic; Antimicrobial; Antiviral; Choroiditis; Endophthalmitis; Infectious vitritis; Intravitreal penetration; Posterior segment; Retina; Retinitis.