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Ciprofloxacin-resistant Pseudomonas keratitis.

P Garg1, S Sharma, G N Rao

  • 1Sight Savers' Corneal Training Centre, Hyderabad, India. prashant@lvpeye.stph.net

Ophthalmology
|July 16, 1999
PubMed
Summary

Emerging ciprofloxacin resistance in Pseudomonas keratitis is a growing concern. Initial treatment with ciprofloxacin often fails, necessitating susceptibility testing and alternative antibiotic therapy for effective outcomes.

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Area of Science:

  • Ophthalmology
  • Microbiology
  • Infectious Diseases

Background:

  • Pseudomonas keratitis is a serious ocular infection.
  • Ciprofloxacin is a commonly used antibiotic for bacterial keratitis.

Purpose of the Study:

  • To determine the prevalence of ciprofloxacin resistance in corneal Pseudomonas isolates.
  • To evaluate the clinical response to topical ciprofloxacin in cases of resistant Pseudomonas keratitis.

Main Methods:

  • Retrospective case series of 141 culture-proven Pseudomonas keratitis cases.
  • Antibiotic susceptibility testing (Kirby-Bauer disc diffusion and agar dilution) was performed.
  • Clinical outcomes were assessed for patients initially treated with 0.3% ciprofloxacin.

Main Results:

  • Twenty-two cases (15.6%) exhibited ciprofloxacin-resistant Pseudomonas isolates (MIC ≥16 µg/ml).
  • Seventy-seven percent of patients initially treated with ciprofloxacin showed no improvement.
  • Modifying therapy based on susceptibility testing led to resolution in all cases.

Conclusions:

  • Emerging ciprofloxacin resistance in Pseudomonas isolates is a significant clinical issue.
  • Empirical monotherapy with ciprofloxacin for infectious keratitis requires critical re-evaluation.
  • Antimicrobial susceptibility testing is crucial for guiding treatment of resistant Pseudomonas keratitis.

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