Intravitreal administration of broad-spectrum antibiotics is a widely accepted component of initial therapy for bacterial endophthalmitis. Four cases of culture-proved bacterial endophthalmitis are reported to demonstrate the safety of intravitreal administration of amikacin sulfate in conjunction with cephalosporins in patients. The benefits of using amikacin rather than gentamicin sulfate in intravitreal drug therapy are discussed, and a wider role for amikacin as the aminoglycoside of choice for initial intravitreal injection in presumed bacterial endophthalmitis is suggested.