• Aprokam is specifically formulated for IC administration
• It reduces the risk of endophthalmitis following cataract surgery^8-12
• Aprokam is the first licensed intracameral cefuroxime for the prophylaxis of postoperative endopthalmitis after cataract surgery

It allows hospitals to comply with RCO and NICE recommendations for the use of antibiotic prophylaxis during cataract surgery^{13, 14}

• The largest study to show the benefit of IC cefuroxime was conducted between 2003 and 2006 by the ESCRS (European Society of Cataract and Refractive Surgeons) in 16,000 patients. This study reported a 4.6-fold reduction in post-operative endopthalmitis with use of IC injection of cefuroxime 1 mg at the end of cataract surgery; this has now been adopted as standard practice in the majority of UK hospitals.¹⁵
• The most recent NICE Guidelines for Cataract Surgery 2017 also recommend the use of IC cefuroxime during cataract surgery to prevent endopthalmitis.¹⁴
• The RCO has highlighted risks associated with patients receiving excessive doses of cefuroxime due to dilution errors with unlicensed forms of IC cefuroxime¹³

SMC Advice

https://www.scottishmedicines.org.uk/medicines-advice/cefuroxime-aprokam-abbreviatedsubmission-93213/

AWMSG Appraisal

http://www.awmsg.org/awmsgonline/app/appraisalinfo/2224

Aprokam must be administered by intracameral injection, by an ophthalmic surgeon in the recommended aseptic conditions of cataract surgery.

For Adults the recommended dose is 0.1ml of reconstituted solution, i.e. 1mg of cefuroxime.

DO NOT INJECT MORE THAN THE RECOMMENDED DOSE.

Paediatric population: The optimal dose and the safety of Aprokam have not been established in the paediatric population.

Vial is for single use only.

Store below 25°C. Keep the vial in the outer carton, in order to protect from light.

The product should be used immediately after reconstitution and not reused.

8ml type I glass vial with stopper and sealed with flip-off cap.

Box of 10 × 50mg vials together with 10 5-micron sterile filter needles.

Hospital only product

NHS Price: £49.95 for a box of 10 vials and 10 filter needles

PIP code: 377-6598

1. Delyfer MN et al. J Cataract Refract Surg 2011;37:271-278
2. Olavi P. Acta Ophthalmol 2012
3. Lockington D et al. J Cataract Refrac Surg 2010;36:286-289
4. Carbonne M et al. Eur J Hosp Pharm 2012;19:153
5. Fleury-Souverain S et al. Eur J Hosp Pharm 2014;21:34-38.
6. McNeil R. Eye News magazine 2015; August/Sept 22:6-9
7. Herrington, LJ et al. Ophthalmology 2016;123:287-294
8. ESCRS. J Cataract Refract Surg 2007; 33: 978-988
9. Friling E et al. J Cataract Refract Surg 2013;39:15-21
10. Yu-Wai-Man P et al. J Cataract Refract Surg 2008;34:447-451
11. Myneni J et al. J Hosp Infec 2013;84:326-328
12. Rahman N et al. Ir J Med Sci 2015;184:395-398
13. Royal College of Ophthalmologists. (https://www.rcophth.ac.uk/2018/05/ophthalmic-safety-alert-intracameral-cefuroxime/
14. NICE Guideline NG77. Cataracts in adults: management. Full guideline. October 2017.
15. Barry P et al. ESCRS guidelines on prevention, investigation and management of post‐operative endophthalmitis. Version 2. 1‐37. The European Society for Cataract & Refractive Surgeons. 2007.