Management of bacterial corneal ulcers

A prospective microbiological study of 48 patients with corneal ulcers due to bacterial infection was performed. Positive cultures of corneal ulcer samples were obtained in 60% of all patients; about half of these patients had received antimicrobial treatment prior to sampling. A relatively high incidence of Staphylococcus epidermidis was isolated from ulcer patients (27%) compared with normal controls (10%). Gram stains of ulcer samples were positive for organisms in only 27% of all patients and were not considered useful in determining initial therapy in this series. We concluded that treatment should be started with a broad combination of antibiotics while awaiting the culture results.