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Published on: November 12, 2015
Initial treatment of microbial keratitis
C L Blanton1, C J Rapuano, E J Cohen
1Cornea Department, Wills Eye Hospital, Philadelphia, PA, USA.
Purpose:
The common occurrence of failed medical treatment in microbial keratitis led us to investigate this phenomenon.
Methods:
We retrospectively reviewed all ulcers that presented to our department for 24 consecutive months. We classified each ulcer as either a therapeutic success or failure based on a precise definition of the response to initial antibiotic selection. We then analyzed multiple factors including: antibiotic selection, ophthalmic disease, ulcer characteristics, and management, to determine their significance in the success or failure in treating microbial keratitis. Complications were also examined.
Results:
Important factors in failure were non-fortified antibiotics (P < 0.001), ocular surface disease (P = 0.0178) and outpatient management (P < 0.001). Large ulcers (P = 0.051) were of borderline significance. Sensitivity results reflect high sensitivity among successfully treated patients when appropriate antibiotics are chosen.
Conclusions:
This report provides insight into current practice patterns and potential means to improve success in managing microbial keratitis.
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