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Severe Keratitis Caused by Pseudomonas aeruginosa Successfully Treated with Ceftazidime Associated with Acetazolamide

Benoit Hue1, Marc Doat, Gilles Renard

  • 1Department of Pharmacy, Pharmacology, and Toxicology, Hotel-Dieu, 1 Place Notre-Dame, 75004 Paris, France.

Journal of Ophthalmology
|March 27, 2010
PubMed

Insights

This case report details a Pseudomonas aeruginosa keratitis treatment combining ceftazidime with acetazolamide. Acetazolamide enhanced antibiotic effectiveness by altering anterior chamber pH, leading to rapid infection eradication.

Area of Science:

  • Ophthalmology
  • Microbiology
  • Pharmacology

Background:

  • Microbial keratitis, particularly Pseudomonas aeruginosa infections, poses a significant threat to vision.
  • Standard antibiotic treatments can face challenges with efficacy and resistance.
  • Understanding drug pharmacokinetics within the eye is crucial for optimizing treatment.

Observation:

  • A 17-year-old female contact lens wearer presented with severe Pseudomonas aeruginosa keratitis.
  • Initial topical antibiotic treatment resulted in temporary improvement followed by relapse.
  • The patient received combined topical and intravenous ceftazidime with oral acetazolamide.

Findings:

  • Acetazolamide, a carbonic anhydrase inhibitor, was administered to decrease anterior chamber pH.
  • This intervention reduced ceftazidime ionization, increasing its concentration in the aqueous humor.
  • The combined therapy led to rapid clinical improvement and eradication of the Pseudomonas aeruginosa infection.

Implications:

  • This is the first reported case demonstrating acetazolamide as an effective enhancer for ceftazidime in treating P. aeruginosa keratitis.
  • The findings suggest a novel therapeutic strategy to improve antibiotic penetration and efficacy in ocular infections.
  • Further research into pH modulation for enhanced ocular drug delivery is warranted.

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