Fluoroquinolones in the treatment of bacterial keratitis

Am J Ophthalmol. 1996 Jun;121(6):712-5. doi: 10.1016/s0002-9394(14)70641-5.

Abstract

Purpose: We evaluated the potential role of three topical fluoroquinolones in the treatment of bacterial keratitis by means of a laboratory database.

Methods: Antibiotic susceptibilities were determined for 153 isolates from patients with bacterial keratitis. Results were analyzed for each fluoroquinolone individually and in combination with cefazolin.

Results: Predicted susceptibility to each cefazolin-fluoroquinolone combination (98.7%) was superior to that for single-agent therapy with ofloxacin (88.2%), ciprofloxacin (82.3%), or norfloxacin (80.4%) (P = .0002). A cefazolin-fluoroquinolone combination (98.7%) was comparable to a cefazolin-gentamicin combination (97.4%).

Conclusions: Combination therapy with cefazolin and a fluoroquinolone offers a reasonable alternative for the treatment of bacterial keratitis. Single-agent therapy with fluoroquinolones for vision-threatening bacterial keratitis is not advised.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents / pharmacology
  • Anti-Infective Agents / therapeutic use*
  • Cefazolin / pharmacology
  • Cefazolin / therapeutic use
  • Cephalosporins / pharmacology
  • Cephalosporins / therapeutic use
  • Corneal Ulcer / drug therapy*
  • Corneal Ulcer / microbiology
  • Drug Therapy, Combination
  • Eye Infections, Bacterial / drug therapy*
  • Eye Infections, Bacterial / microbiology
  • Fluoroquinolones
  • Gentamicins / pharmacology
  • Gentamicins / therapeutic use
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Positive Bacteria / drug effects
  • Gram-Positive Bacteria / isolation & purification
  • Humans
  • Microbial Sensitivity Tests
  • Ophthalmic Solutions

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Cephalosporins
  • Fluoroquinolones
  • Gentamicins
  • Ophthalmic Solutions
  • Cefazolin