가. 녹농균이 증명되었을 때, 임상적으로 녹농균 감염이 의심되거나 가능성이 있는 경우 교과서적 근거에 의한 경험적 치료
나. 동 제제를 포함한 3세대 Cephalosporin에 대한 감수성이 있는 경우
2. 허가사항 범위를 초과하여 성인에서 세균성 안내염으로 의심 또는 진단되는 경우 아래와 같은 기준으로 투여 시 요양급여를 인정함.
- 아 래 -
1)투여 방법: 유리체강 내 주사(2mg/0.1ml 또는 2.25mg/0.1ml)
2) 투여간격: 임상 소견(염증 및 감염 조절 상태)에 따라 2일 이상 간격으로 투여
3)병용투여: 임상 소견에 따라 Vancomycin과 병용 투여가 필요한 경우 Vancomycin 주사제 급여 기준에 따라 투여
■ 고시 개정 고시번호(시행일자)
고시 제2025-73호(2025.5.1.)
■ 고시 개정 사유
○ 교과서, 가이드라인, 임상논문, 학회(전문가) 의견 등을 참조하여 허가사항을 초과하여 성인의 세균성 안내염에 유리체강 내 주사를 급여 인정하며 약제급여목록의 품목으로 현행화함.
■ 관련근거
· Ryan’s Retina, 7th edition
· Kanski's Synopsis of Clinical Ophthalmology, 4th edition
· Ophthalmology, 6th edition
· Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 14th edition
· 2013 ESCRS(European Society of Cataract and Refractive Surgeons) Guidelines for Prevention and Treatment of Endophthalmitis Following Cataract Surgery: Data, Dilemmas and Conclusions
· 2019 AAO(American Academy of Ophthalmology) International Practice Patterns for the Management of Acute Postsurgical and Postintravitreal Injection Endophthalmitis
· 2016 APAO(Asia Pacific Academy of Ophthalmology) The Latest Updates and Management of Endophthalmitis
· 2023 Consensus and controversies in the science of endophthalmitis management: Basic research and clinical perspectives, Progress in Retinal and Eye Research 97 (2023) 1350-9462, Elsevier
· 2021 Pediatric endophthalmitis: clinical profile, outcomes, and a proposed protocol, Graefe’s Archive for Clinical and Experimental Ophthalmology
· Endophthalmitis Vitrectomy Study Group. Results of the Endophthalmitis Vitrectomy Study A Randomized Trial of Immediate Vitrectomy and of Intravenous Antibiotics for the Treatment of Postoperative Bacterial Endophthalmitis, Arch Ophthalmol. 1995;113:1479-1496
· Taraprasad Das et al, Endophthalmitis Management Study―A Prospective Randomized Clinical Trial on Postoperative Endophthalmitis Management in India: An Interim Analysis. Endophthalmitis Management Study Report #3, Asia Pac J Ophthalmol (Phila) 2023;12:437？443
· Kim et el., Adjunctive steroid therapy versus antibiotics alone for acute endophthalmitis afer intraocular procedure (Review), Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No.: CD012131.
· Issa et el., Pars plana vitrectomy versus intravitreal antibiotics for endophthalmitis management following intravitreal anti-VEGF agents: A meta-analysis, Acta Ophthalmologica. 2024;102:e11？e21.
· Tiecco et el., Gram-Negative Endogenous Endophthalmitis: A Systematic Review. survey of ophthalmology 59 (2014) 627-635
· Nam et al., Clinical features of infectious endophthalmitis in South Korea: a five-year multicenter study. BMC Infectious Diseases (2015) 15:177
· Michael et al., Rapid treatment of endophthalmitis with intravitreal antibiotics is associated with better vision outcomes. Clin Experiment Ophthalmol. 2023;51:137？143.