The Value of Fortified Aminoglycoside/Cephalosporin Treatment as First-Line Treatment and in Fluoroquinolone-Resistant Bacterial Keratitis
Journal Title: Turkish Journal of Ophthalmology - Year 2020, Vol 50, Issue 5
Abstract
Objectives: Topical application of fluoroquinolone antibiotics is thought to be as effective as fortified antibiotics. The aim of this study was to evaluate the efficacy of fluoroquinolones as an alternative to fortified antibiotic therapies. Materials and Methods: The medical records of 31 patients who were hospitalized in our department due to bacterial keratitis were retrospectively reviewed. Fluoroquinolone was started as the first treatment for 20 (64.5%) patients and upon no response fortified antibiotic was initiated, and 11 (35.5%) patients were started with fortified treatment. Cultures and smears were recorded before treatment. Lesions were evaluated as superficial or deep according to their depth. Treatment response was evaluated based on reduction of infiltrate depth and size, change in visual acuity, and regression of hypopyon. Results: Central, paracentral, and peripheral location were detected in 9 (29.0%), 10 (32.2%) and 12 (38.7%) eyes, respectively. According to lesion depth, 15 (48.3%) were deep and 16 (51.6%) were superficial. Response of superficial lesions was found to be statistically earlier (p=0.037). Culture was positive in 9 (29.0%) eyes. The initial best corrected visual acuity (BCVA) was 0.5±0.7 logMAR (-0.1-2.3) and 0.3±0.3 logMAR (-0.1-0.9) after treatment. Treatment response showed moderate but statistically nonsignificant correlation with time to treatment initiation and initial BCVA (r=0.527, p=0.184; r=0.517, p=0.120). Conclusion: Although fluoroquinolones are the first choice for the treatment of bacterial keratitis, fortified antibiotics have been shown to be effective in patients who do not respond to treatment. Fortified therapy should be kept in mind in the treatment of bacterial keratitis.
Authors and Affiliations
Özlem Dikmetaş, Yağmur Deniz, Sibel Kocabeyoğlu, Merve Başol, Murat İrkeç
Keywords
Related Articles
- EP ID EP689931
- DOI 10.4274/tjo.galenos.2020.37346
- Views 177
- Downloads 0
Unusual Association of Inverse Retinitis Pigmentosa, Scleromalacia, and Neovascular Glaucoma
A 31-year-old woman with inverse retinitis pigmentosa presented with severe ocular pain and ingrained visual loss. Biomicroscopy revealed a large scleromalacia area above the superior limbus, minimal Descemet’s membrane...
Artificial Intelligence and Ophthalmology
Artificial intelligence is advancing rapidly and making its way into all areas of our lives. This review discusses developments and potential practices regarding the use of artificial intelligence in the field of ophthal...
The Effect of Topical Cyclopentolate on Anterior Segment Parameters in Patients with Keratoconus
Objectives: To investigate the effect of cycloplegia on anterior segment structures in keratoconus and forme fruste keratoconus patients using corneal topography. Materials and Methods: In this study, 40 patients with k...
Acute Macular Neuroretinopathy in Purtscher Retinopathy
Purtscher retinopathy and acute macular neuroretinopathy are two rare clinical disorders that are both probably associated with ischemic pathogenesis. In this report, we describe for the first time the coexistence of Pur...
Use of a Mini-Scleral Lens in Patients with Keratoconus
Objectives: To assess the visual performance of a mini-scleral lens in patients with keratoconus and to evaluate its fit by optical coherence tomography (OCT). Materials and Methods: Twenty-nine eyes of 24 patients with...