UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000044376
Receipt number R000050690
Scientific Title Antibiotic prophylaxis of endophthalmitis after cataract surgery: network meta-analysis
Date of disclosure of the study information 2021/05/31
Last modified on 2022/11/18 16:59:47

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Basic information

Public title

Antibiotic prophylaxis of endophthalmitis after cataract surgery: network meta-analysis

Acronym

Antibiotic prophylaxis of endophthalmitis after cataract surgery: network meta-analysis

Scientific Title

Antibiotic prophylaxis of endophthalmitis after cataract surgery: network meta-analysis

Scientific Title:Acronym

Antibiotic prophylaxis of endophthalmitis after cataract surgery: network meta-analysis

Region

Japan


Condition

Condition

endophthalmitis after cataract surgery

Classification by specialty

Ophthalmology

Classification by malignancy

Others

Genomic information

NO


Objectives

Narrative objectives1

Cataract surgery is the most commonly performed procedure in many industrialized countries, and its frequency continues to increase. Reasons for this include changes in the demographic composition of the population, improved technologies.
Endophthalmitis is an inflammation of the lumen of the eye, usually caused by an infection. It is a possible complication of all intraocular surgeries, especially cataract surgery, and can lead to loss of vision. The most common cause of postoperative endophthalmitis is bacteria directly inoculated by the surgery. Therefore, perioperative antibiotic is a reasonable strategy to reduce the risk of postoperative endophthalmitis. In daily practice, a variety of antibiotics has been used to prevent post-operative endophthalmitis and they can be administrated as irrigation during the operation, intracameral injection, or topical administration. However, benefit of antibiotic use had not been sufficiently clear until recently mainly because incidence of post cataract surgery endophthalmitis is less than 0.1%. Thus, pooled analysis was warranted for this topic. Published meta-analyses revealed that perioperative intracameral vancomycin/moxifloxacin, anterior chamber injection of moxifloxacin after cataract surgery, and intracameral cefuroxime and moxifloxacin after cataract surgery reduce the risk of endophthalmitis compared to no antibiotic prophylaxis. However, the best antibiotic type and the best administration route for cataract surgery are still not known. The current systematic review is to reveal the preferred antibiotics using data from both randomized controlled trials and observational studies.

Basic objectives2

Efficacy

Basic objectives -Others


Trial characteristics_1


Trial characteristics_2


Developmental phase



Assessment

Primary outcomes

endophthalmitis after cataract surgery

Key secondary outcomes



Base

Study type

Others,meta-analysis etc


Study design

Basic design


Randomization


Randomization unit


Blinding


Control


Stratification


Dynamic allocation


Institution consideration


Blocking


Concealment



Intervention

No. of arms


Purpose of intervention


Type of intervention


Interventions/Control_1


Interventions/Control_2


Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit


Not applicable

Age-upper limit


Not applicable

Gender

Male and Female

Key inclusion criteria

Both randomized controlled trials and observational studies will be included as long as they were written in English language and provided sufficient data. Conference abstract are permitted.

Eyes with cataracts after surgery will be analyzed.

Key exclusion criteria

NA

Target sample size



Research contact person

Name of lead principal investigator

1st name Nobuyuki
Middle name
Last name Horita

Organization

Yokohama City University Hospital

Division name

Chemotherapy Center

Zip code

236-0004

Address

3-9, Kanazawa, Fukuura, Yokohama

TEL

+810081457872800

Email

horitano@yokohama-cu.ac.jp


Public contact

Name of contact person

1st name Nobuyuki
Middle name
Last name Horita

Organization

Yokohama City University Hospital

Division name

Chemotherapy Center

Zip code

236-0004

Address

3-9, Kanazawa, Fukuura, Yokohama

TEL

+810081457872800

Homepage URL


Email

horitano@yokohama-cu.ac.jp


Sponsor or person

Institute

Yokohama City University Hospital

Institute

Department

Personal name



Funding Source

Organization

Yokohama City University Hospital

Organization

Division

Category of Funding Organization

Self funding

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization

Yokohama C

Address

3-9, Kanazawa, Fukuura, Yokohama

Tel

+810081457872800

Email

horitano@yokohama-cu.ac.jp


Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions



Other administrative information

Date of disclosure of the study information

2021 Year 05 Month 31 Day


Related information

URL releasing protocol

https://pubmed.ncbi.nlm.nih.gov/36258003/

Publication of results

Published


Result

URL related to results and publications

https://pubmed.ncbi.nlm.nih.gov/36258003/

Number of participants that the trial has enrolled

6809732

Results

Intracameral injection of vancomycin had the best preventive effect (odds ratio [OR] 0.03, 99.6% confidence interval [CI] 0.00-0.53, corrected P-value = 0.006, P-score = 0.945) followed by intracameral injection of cefazoline (OR 0.09, 99.6% CI 0.02-0.42, corrected P-value < 0.001, P-score = 0.821), cefuroxime (OR 0.18, 99.6% CI 0.09-0.35, corrected P-value < 0.001, P-score = 0.660), and moxifloxacin (OR 0.36, 99.6% CI 0.16-0.79, corrected P-value = 0.003, P-score = 0.455).

Results date posted

2022 Year 11 Month 18 Day

Results Delayed


Results Delay Reason


Date of the first journal publication of results


Baseline Characteristics

See:
Ai Kato et al. Sci Rep. 2022 Oct 18;12(1):17416. doi: 10.1038/s41598-022-21423-w.

Participant flow

See:
Ai Kato et al. Sci Rep. 2022 Oct 18;12(1):17416. doi: 10.1038/s41598-022-21423-w.

Adverse events

See:
Ai Kato et al. Sci Rep. 2022 Oct 18;12(1):17416. doi: 10.1038/s41598-022-21423-w.

Outcome measures

See:
Ai Kato et al. Sci Rep. 2022 Oct 18;12(1):17416. doi: 10.1038/s41598-022-21423-w.

Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Main results already published

Date of protocol fixation

2021 Year 05 Month 31 Day

Date of IRB

2021 Year 05 Month 31 Day

Anticipated trial start date

2021 Year 05 Month 31 Day

Last follow-up date

2021 Year 05 Month 31 Day

Date of closure to data entry


Date trial data considered complete


Date analysis concluded



Other

Other related information

Any antibiotics via any route will be accepted. Combined regimen with two or more antibiotics were also allowed.
Newcastle-Ottawa quality assessment scale for cohort studies will be used for quality assessment.
Treatment arm should be determined by both antibiotics type and administration route for the main analysis. Sensitivity analyses focusing on only antibiotic type and only administration route are planned.
Proportion of eyes with endophthalmitis will be compared between the two treatment groups using odds ratios (ORs). If one or more cells are null in a two-by-two contingency table, 0.5 will be added to all cells as continuity correction. The logarithm of the ORs and their standard errors will be pooled by the "netmeta" package in R. The logarithm of ORs and their standard errors will be pooled by frequentist weighted least squares approach random-model network meta-analysis.


Management information

Registered date

2021 Year 05 Month 31 Day

Last modified on

2022 Year 11 Month 18 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000050690


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name