Fortified antibiotic agents are needed for the management of keratitis

An investigation in the Journal of Cataract and Refractive Surgery strongly suggests the use of fortified antibiotic agents for prevention of vision loss in infectious keratitis patients.

Dr Vitoria de Rojas et al., Instituto Oftalmológico Europeo, Coruña, Spain, conducted a multicentred case series study on 9794 patients with infectious keratitis who underwent surface ablation between January 2003 and December 2009. The main outcome measures included incidence of infectious keratitis after surface ablation, ulture results, response to treatment, and visual outcomes. The team recorded incidence, risk factors, clinical course, days to diagnosis, medical and surgical treatment, and visual outcome.

Infectious keratitis after surface ablation was found in 39 eyes of 38 patients and the onset of infection occurred within 7 days of surgery in 28 cases. From the samples taken it was found that 13 of 27 cases had positive cultures- with the most frequent microorganism being the Staphylococcus species in 9 patients.

In 23 patients the final corrected distance visual acuity (CDVA) was 20/20 or better, 20/40 or better in 36 patients and worse then 20/40 in 3 patients. The occurrence of infectious keratitis after surface ablation was 0.20% and was considered potentially sight threatening.

The study suggested the immediate use of fortified antibiotic agents for the management of infectious keratitis- meaning vision is more likely to be preserved in most incidences.