vancomycin + amikacin

This refers to the intravitreal antibiotic regimen established by the Endophthalmitis Vitrectomy Study (EVS), a landmark Phase 3 randomized clinical trial sponsored by the National Eye Institute (NEI) and published in 1995. The regimen consists of a combination of two small molecule antibiotics: vancomycin (1 mg) and amikacin (0.4 mg), administered via direct injection into the vitreous cavity of the eye. Vancomycin is a glycopeptide antibiotic that inhibits bacterial cell wall synthesis by binding to the D-alanyl-D-alanine portion of peptidoglycan precursors, primarily targeting Gram-positive organisms. Amikacin is an aminoglycoside antibiotic that inhibits protein synthesis by binding to the 30S ribosomal subunit, targeting Gram-negative organisms. The EVS was a pivotal study that demonstrated the efficacy of these intravitreal antibiotics in treating acute postoperative bacterial endophthalmitis following cataract surgery, while also showing that systemic intravenous antibiotics did not provide additional therapeutic benefit.

Other names

EVS antibiotic regimenEndophthalmitis Vitrectomy Study antibiotic regimenintravitreal vancomycin and amikacin