Antibiotic prophylaxis for corneal abrasion

Area of Science:

• Ophthalmology
• Infectious Diseases
• Evidence-Based Medicine

Background:

• Corneal abrasion is common and often treated with topical antibiotics.
• Evidence on antibiotic prophylaxis for traumatic corneal abrasion is not comprehensively synthesized.
• This review updates previous findings on antibiotic benefits and harms.

Purpose of the Study:

• To assess the benefits and harms of topical antibiotic prophylaxis for corneal abrasion.

Main Methods:

• Included randomized controlled trials (RCTs) comparing antibiotics with placebo or other antibiotics.
• Searched multiple databases and trials registries up to March 2025.
• Assessed risk of bias and synthesized evidence using meta-analysis and GRADE.

Main Results:

• Four RCTs with 998 participants were included; evidence certainty was very low.
• Antibiotics may increase ocular infection risk (RR 1.32) versus placebo, with no significant difference in healing.
• No significant differences in infection or healing were found when comparing chloramphenicol with other antibiotics.

Conclusions:

• Very low certainty evidence prevents supporting specific antibiotic regimens for corneal abrasion.
• Conclusions on preventing ocular infection or accelerating healing cannot be drawn.
• Future research should focus on adequately powered RCTs for high-risk populations.