Topical corticosteroids as adjunctive therapy for bacterial keratitis

Area of Science:

• Ophthalmology
• Infectious Diseases
• Pharmacology

Background:

• Bacterial keratitis is a severe eye infection potentially causing vision loss.
• Risk factors include contact lens wear, ocular surface disease, and trauma.
• Topical antibiotics are standard treatment, but corticosteroid use is debated.

Purpose of the Study:

• To assess the effectiveness and safety of topical corticosteroids (TCS) as adjunctive therapy for bacterial keratitis.
• To evaluate health economic and quality of life outcomes.

Main Methods:

• Systematic review of four randomized controlled trials (RCTs).
• Included RCTs compared TCS plus antibiotics versus antibiotics alone.
• Searched multiple databases up to July 2014.

Main Results:

• No significant difference in visual acuity between groups.
• One study suggested slower re-epithelialization with steroids, but the main trial found no difference.
• No significant difference in adverse events, though one trial noted more intraocular pressure elevation in the control group.

Conclusions:

• Inadequate evidence exists on the effectiveness and safety of adjunctive TCS for bacterial keratitis.
• Current evidence does not strongly support corticosteroid use, possibly due to insufficient trial power.