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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.
Summary
Treatment failure in microbial keratitis is common. Key factors contributing to failure include non-fortified antibiotics, ocular surface disease, and outpatient management, highlighting areas for improved therapeutic success.
Area of Science:
- Ophthalmology
- Microbiology
- Infectious Diseases
Background:
- Microbial keratitis is a significant cause of vision loss worldwide.
- Failed medical treatment for microbial keratitis presents a challenge in clinical practice.
Purpose of the Study:
- To investigate factors contributing to treatment failure in microbial keratitis.
- To identify key elements influencing the success or failure of initial antibiotic selection for microbial keratitis.
Main Methods:
- Retrospective review of microbial keratitis cases over 24 months.
- Classification of ulcers as therapeutic success or failure based on response to initial antibiotic therapy.
- Analysis of factors including antibiotic selection, ocular disease, ulcer characteristics, and management strategies.
Main Results:
- Non-fortified antibiotics, ocular surface disease, and outpatient management were significant factors in treatment failure (P < 0.001, P = 0.0178, P < 0.001 respectively).
- Large ulcer size showed borderline significance (P = 0.051).
- High antibiotic sensitivity was observed in successfully treated patients with appropriate antibiotic selection.
Conclusions:
- Understanding practice patterns is crucial for improving microbial keratitis management.
- Optimizing antibiotic selection and considering patient management settings can enhance treatment outcomes for microbial keratitis.
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