Use of corticosteroids in combination with antimicrobial drugs in the treatment of infectious corneal disease.

The use of corticosteroids in the management of infectious eye disease is controversial. In this study, the authors attempt to analyze the goals and risks of the use of corticosteroids in the treatment of various forms of infectious keratitis with reference to generally recognized principles for the treatment of infectious diseases. Existing clinical and research data are reviewed in this context to make appropriate recommendations for the use of corticosteroids in the treatment of bacterial, fungal, and acanthamoeba keratitis. The authors conclude that corticosteroids are definitely contraindicated in the treatment of fungal keratitis, and relatively contraindicated in the treatment of Acanthamoeba keratitis. Topical corticosteroid therapy may have a role in the treatment of bacterial keratitis if appropriate guidelines are followed.