Keratitis, bacterial treatment

Efficacy In other conditions The clinical efficacy in the treatment of stromal keratitis and uveitis caused by herpes simplex or ophthalmic infections caused by vaccinia virus and adenovirus, or in the prophylaxis of herpes simplex virus keratoconjunctivitis and epithelial keratitis has not been established by well-controlled clinical trials. Not effective against bacterial, fungal, or chlamydial infections of the cornea or trophic lesions. 

I Unlabeled Uses Treatment of bacterial blepharitis, blepharoconjunctivitis, bacterial keratitis, keratoconjunctivitis... 

Bacterial keratitis is one of the most frequent ophthalmic infections. In a meta-analysis of publications from 1950 to 2000, the use of a topical glucocorticoid before the diagnosis of bacterial keratitis significantly predisposed to ulcerative keratitis in eyes with preexisting corneal disease (OR = 2.63 95% Cl = 1.41, 4.91). Previous glucocorticoid use significantly increased the risk of antibiotic failure or other infectious complications (OR = 3.75 95% Cl = 2.52, 5.58). The use of glucocorticoids with an antibiotic for the treatment of bacterial keratitis did not increase the risk of complications, but neither did it improve the outcome of treatment. 

Ghelardi, E., et al. 2004. A mucoadhesive polymer extracted from tamarind seed improves the intraocular penetration and efficacy of rufloxacin in topical treatment of experimental bacterial keratitis. Antimicrob Agents Chemother 48 3396. 

Ghelardi, E., Tavanti, A., Davini, P., Celandroni, F., Salvetti, S., Parisio, E., Boldrini, E., Senesi, S. and Campa, M. (2004) A mucoadhesive polymer extracted from tamarind seed improves the intraocular penetration and efficacy of rufloxacin in topical treatment of experimental bacterial keratitis. Antimicrobial Agents and Chemotherapy 48(9), 3396-3401. 

All the available ophthalmic fluoroquinolones are indicated for bacterial conjunctivitis with a treatment regimen of usually one to two drops four times a day. However, because the newer gatifloxacin and moxifloxacin have wider spectra and less resistance, they should probably be reserved for treatment of the more serious infection, bacterial keratitis. 

Although the fourth-generation drugs, moxifloxacin and gatifloxacin, are not approved for treatment of bacterial keratitis, they are now the preferred fluoroquinolones for this disease. They have wide spectra of activity and lesser resistance by the common corneal pathogens, especially the gram-positive cocci. 

Leibowitz HM. Clinical evaluation of ciprofloxacin 0.3% ophthalmic solution for treatment of bacterial keratitis. Am J Ophthalmol 1991 112(suppl) S34-S47. 

Parmar R Salman A, Kalavathy CM, et al. Comparison of topical gatifloxacin 0.3% and ciprofloxacin 0.3% for the treatment of bacterial keratitis. AmJ Ophthalmol 2006 141 282-286. 

Ciprofloxacin, which is available in an aqueous 0.3% ophthalmic solution and an ointment farm, has a broad spectrum of action. Ciprofloxacin has been shown to be at least as successful in treating corneal ulceration as fortified antibiotics however, as mentioned earlier, there appears to be an increasing number of resistant strains since its introduction. The usual dosage of ciprofloxacin solution for the treatment of bacterial ulcers is two drops every 15 minutes for 6 hours, then two drops every 30 minutes for 18 hours, followed by two drops every hour for 24 hours. Ciprofloxacin is then used every 4 hours for the next 12 days. Ciprofloxacin ointment also is effective in the treatment of bacterial keratitis. It is applied every 1 to 2 hours in the first 2 days and then every 4 hours for the next 12 days. 

The patient with Acanthamoeba keratitis typically presents with symptoms of redness, irritation, severe pain due to radial neuritis, photophobia, and reduced visual acuity. History of corneal contamination with water, saliva, or vegetative matter may be elicited with careful questioning. The duration of symptoms may vary from days to weeks, with waxing and waning of signs and symptoms common. Not infrequently, the condition has been present for weeks or months, and treatment with multiple agents for viral or bacterial keratitis had been attempted without result. 

Misyn, F.A., Besedin, E.V, Obraztsova, A.M., Gostev, VA. (2000c), Experimental Curing of Bacterial Ulcerous Keratitis with Cold Plasma, in Diagnostics and Treatment of Infectious Diseases, Petrozavodsk University,... 

Sensoy, D., Cevher, H., Sanci, A., Yilmaz, M., Ozdamar, A., Bergifadi, N., 2009. Bioadhesive sulfacetamide sodium microspheres evaluation of their effectiveness in the treatment of bacterial keratitis caused by Staphylococcus aureus and Pseudomonas aeruginosa in a rabbit model. European Journal of Pharmaceutics Biopharmaceutics 72 (3), 487—495. 

Ustundag-Okur N, et al. Preparation and in vitro-in vivo evaluation of ofloxacin loaded ophthalmic nano structured hpid carriers modified with chitosan oligosaccharide lactate for the treatment of bacterial keratitis. Eur J Pharm Sci 2014 63 204-15. 

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