Antibiotic prophylaxis for corneal abrasion

Area of Science:

• Ophthalmology
• Infectious Diseases
• Evidence-Based Medicine

Background:

• Corneal abrasion is a common eye injury managed by various physicians.
• Ocular antibiotics are a potential treatment, but evidence on their prophylactic use is limited.
• This review synthesizes current evidence on antibiotic prophylaxis for traumatic corneal abrasions.

Purpose of the Study:

• To assess the safety and efficacy of topical antibiotic prophylaxis after corneal abrasion.
• To investigate infection rates with antibiotics versus placebo or alternative antibiotics.
• To evaluate the time to clinical cure (epithelial healing) with antibiotic treatment.

Main Methods:

• Searched multiple databases including CENTRAL, MEDLINE, Embase, PubMed, LILACS, ClinicalTrials.gov, and ICTRP.
• Included randomized controlled trials (RCTs) comparing antibiotics with placebo or other antibiotics in adults and children.
• Assessed evidence certainty using the GRADE classification.

Main Results:

• Two RCTs with 527 participants were included; studies had very low to low certainty evidence.
• One study compared chloramphenicol with fusidic acid, finding no significant difference in infection or cure rates, with mild adverse events in both groups.
• Another study compared chloramphenicol-clotrimazole with chloramphenicol-placebo, showing high cure rates in both arms with minimal adverse events.

Conclusions:

• The evidence regarding the benefits of antibiotic prophylaxis for corneal abrasions is of low to very low certainty.
• Current data is insufficient to establish superiority of any antibiotic regimen over another.
• Well-designed RCTs are needed to evaluate antibiotic efficacy and safety, especially in high-risk populations.