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Increased incidence of corneal perforation after topical fluoroquinolone treatment for microbial keratitis

P L Mallari1, D J McCarty, M Daniell

  • 1Centre for Eye Research Australia, University of Melbourne, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.

American Journal of Ophthalmology
|February 13, 2001
PubMed
Abstract

Insights

Topical fluoroquinolone antibiotics showed a significantly higher incidence of corneal perforation in bacterial keratitis cases compared to fortified antibiotics. Ofloxacin specifically was associated with this increased risk, warranting further investigation.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Pharmacology

Background:

  • Microbial keratitis is a serious eye infection that can lead to vision loss.
  • Topical antibiotics are a primary treatment for bacterial keratitis.
  • Fluoroquinolones are commonly used antibiotics, but their safety in severe keratitis requires evaluation.

Purpose of the Study:

  • To compare the risk of corneal perforation in patients with bacterial keratitis treated with topical fluoroquinolones versus fortified antibiotics.
  • To identify specific fluoroquinolone agents associated with adverse outcomes.

Main Methods:

  • Retrospective review of 277 hospitalized patients with bacterial keratitis.
  • Data collected from January 1991 to November 1999.
  • Comparison of corneal perforation rates between treatment groups.

Main Results:

  • Corneal perforation occurred in 12.7% of fluoroquinolone-treated eyes versus 0.7% of fortified antibiotic-treated eyes (P <.001).
  • All perforations in the fluoroquinolone group (14.4%) were linked to ofloxacin treatment.
  • No specific microbial isolate was associated with perforations in ofloxacin-treated eyes.

Conclusions:

  • Topical fluoroquinolone use may increase the risk of corneal perforation in bacterial keratitis.
  • Ofloxacin appears to be particularly associated with this risk.
  • Further research is needed to understand the mechanisms behind this potential association.

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