A Comparative Study of Role of Newer Antibiotics on Bacterial Corneal Ulcer
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 3
Abstract
Introduction: Cornea is a transparent, avascular structure, constituting 1/6th of the anterior fibrous coat eyeball and providing about two thirds of the eye's refractive power. Inflammation or infective condition of the cornea results in disruption of its epithelial layer with involvement of the corneal stroma resulting in a painful condition called as corneal ulcer. Despite the best available treatment options course of the disease is unpredicted and prognosis is uncertain. With the advent of newer antibiotics there is a paradigm shift in the treatment of bacterial corneal ulcer. This study was carried out to study the role of newer antibiotics in the treatment of bacterial keratitis so that the complications and aftermath of corneal ulcer can be overcome. Material and Methods: A prospective, observational, crosssectional study was conducted among patients attending ophthalmology OPD and IPD in a tertiary care teaching hospital of Jharkhand. Results: Total 50 patients with corneal ulcer were studied after meeting the inclusion criteria. Corneal ulcer was more commonly seen in males (59.97%). Most common age group affected was 51-60 years. Gram positive cocci were found in 70% cases followed by gram negative bacilli (16%). Staph aureus was found in 59.58% of isolates and Pseudomonas aeruginosa in 17.02%. History of trauma was noted in 76.59% of cases. Vegetative matters constituted over 65% of cases of trauma. Moxifloxacin and Besifloxacin and to a lesser extent Cefazolin was the most effective antibiotics in most of the cases of bacterial corneal ulcer. Gatifloxacin and Ofloxacin were almost equally effective in gram positive bacteria but are mildly sensitive to Pseudomonas infection. A few cases of Pseudomonas ulcer are resistant to Gatifloxacin, Ofloxacin, Cefazolin and Cephaloridine. Ofloxacin and Tobramycin had better effect of Pseudomonas but had mild effect on gram positive pure and mixed infections. Conclusion: Study suggests most effective therapy to be 0.5% Moxifloxacin for aerobic gram negative organism. Besifloxacin 0.6% was effective in most of Gram positive and Gram negative infections.
Authors and Affiliations
Samuel Aman Toppo, Anuj Kumar Pathak, Puspa Kumari, Marianus Deepak Lakra
Keywords
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