B Steger1, L Speicher, W Philipp, T Gasser, E Schmid, N Bechrakis. 1. Universitätsklinik für Augenheilkunde und Optometrie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich, rotelotto@gmail.com.
Abstract
BACKGROUND: Contact lens-related microbial keratitis is a cause of potentially sight-threatening corneal opacification. Effective initial antimicrobial therapy is crucial to prevent long-term complications. This investigation was undertaken to test the effectiveness of current routine empirical antibiotic treatment regimens. METHODS/PATIENTS: All consecutive cases of contact lens-related keratitis presenting in the outpatient clinic of the Department of Ophthalmology at the Medical University of Innsbruck between January 2010 and April 2012 were retrospectively analyzed. RESULTS: Cultures were positive in 69 out of the 123 cases included in the study. Culture results identified 59.4 % Gram positive strains, 50.7 % Gram negative strains and 7.2 % fungal strains. Mixed infections accounted for 29 % of cases. The combination of an aminoglycoside and a second generation quinolone antibiotic was the most common initial treatment regimen (87.8 %). In vitro this regimen was less effective compared to combinations of moxifloxacin and ciprofloxacin or moxifloxacin and gentamicin. CONCLUSION: Empirical combined regimens remain an effective treatment of contact lens-related keratitis. Fluoroquinolones proved to be inadequate for monotherapy.
BACKGROUND: Contact lens-related microbial keratitis is a cause of potentially sight-threatening corneal opacification. Effective initial antimicrobial therapy is crucial to prevent long-term complications. This investigation was undertaken to test the effectiveness of current routine empirical antibiotic treatment regimens. METHODS/PATIENTS: All consecutive cases of contact lens-related keratitis presenting in the outpatient clinic of the Department of Ophthalmology at the Medical University of Innsbruck between January 2010 and April 2012 were retrospectively analyzed. RESULTS: Cultures were positive in 69 out of the 123 cases included in the study. Culture results identified 59.4 % Gram positive strains, 50.7 % Gram negative strains and 7.2 % fungal strains. Mixed infections accounted for 29 % of cases. The combination of an aminoglycoside and a second generation quinolone antibiotic was the most common initial treatment regimen (87.8 %). In vitro this regimen was less effective compared to combinations of moxifloxacin and ciprofloxacin or moxifloxacin and gentamicin. CONCLUSION: Empirical combined regimens remain an effective treatment of contact lens-related keratitis. Fluoroquinolones proved to be inadequate for monotherapy.
Authors: E C Poggio; R J Glynn; O D Schein; J M Seddon; M J Shannon; V A Scardino; K R Kenyon Journal: N Engl J Med Date: 1989-09-21 Impact factor: 91.245
Authors: Mathias Roth; Paul Goerke; Christoph Holtmann; Andreas Frings; Colin R MacKenzie; Gerd Geerling Journal: Graefes Arch Clin Exp Ophthalmol Date: 2022-06-10 Impact factor: 3.117