0.3% ciprofloxacin ophthalmic ointment in the treatment of bacterial keratitis. The Ciprofloxacin Ointment/Bacterial Keratitis Study Group
K. R. Wilhelmus, R. A. Hyndiuk, D. R. Caldwell, R. L. Abshire, A. T. Folkens and L. B. Godio
Cullen Eye Institute, Baylor College of Medicine, Houston, Tex.
OBJECTIVE: To determine the efficacy and safety of topical 0.3%
ciprofloxacin hydrochloride ophthalmic ointment in the treatment of
bacterial keratitis. DESIGN: Prospective case series with a nonrandomized
comparison of culture-positive, evaluable cases (ciprofloxacin ointment
group) with culture-positive, concurrent patients (nonenrolled group)
treated with conventional therapy. SETTING: Multicenter clinical study.
PATIENTS: After informed consent was obtained, 253 eligible patients
underwent corneal scrapings and received topical ciprofloxacin ointment;
145 (57%) had positive cultures and completed the follow-up schedule. Forty
(70%) of 57 apparently eligible patients had culture-positive bacterial
keratitis but were not enrolled in the ciprofloxacin ointment study during
the same period. INTERVENTION: Ciprofloxacin ophthalmic ointment instilled
every 1 to 2 hours for 2 days, then every 4 hours for 12 days. MAIN OUTCOME
MEASURES: Clinical evaluation of signs at 1, 3, 7, and 14 days of treatment
and the overall condition classified as clinical success (cured or
improved) or failure (unchanged or worse) during and after therapy.
RESULTS: Clinical success with the initial treatment occurred in 135
patients (93%) in the ciprofloxacin ointment group and in 28 patients (70%)
in the nonenrolled group. Of the 10 ciprofloxacin clinical failures, seven
were staphylococcal; two, pneumococcal; and one, polybacterial. The 90%
minimum inhibitory concentration of ciprofloxacin was 3 mg/L or less for
corneal bacterial isolates. No serious adverse event attributable to
ciprofloxacin ointment occurred, although 32 (13%) of 253 patients
developed a transient white crystalline corneal precipitate shown with
liquid chromatography in two cases to be ciprofloxacin. CONCLUSION:
Ciprofloxacin ophthalmic ointment is an effective and safe topical
antimicrobial agent for the treatment of bacterial keratitis caused by
susceptible microorganisms.
Topical ciprofloxacin can delay recovery from viral ocular surface infection
Patwardhan and Khan
JRSM 2005;98:274-275.
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Influence of Fluoroquinolone Susceptibility on the Therapeutic Response of Fluoroquinolone-Treated Bacterial Keratitis
Wilhelmus et al.
Arch Ophthalmol 2003;121:1229-1233.
ABSTRACT
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Overview: Initial antimicrobial therapy for microbial keratitis
Daniell
Br. J. Ophthalmol. 2003;87:1172-1174.
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View 1: Corneal scraping and combination antibiotic therapy is indicated
Mills
Br. J. Ophthalmol. 2003;87:1167-1169.
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Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases
Bourcier et al.
Br. J. Ophthalmol. 2003;87:834-838.
ABSTRACT
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In vitro antibiotic resistance in bacterial keratitis in London
Tuft and Matheson
Br. J. Ophthalmol. 2000;84:687-691.
ABSTRACT
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Lysostaphin Treatment of Methicillin-Resistant Staphylococcus aureus Keratitis in the Rabbit
Dajcs et al.
IOVS 2000;41:1432-1437.
ABSTRACT
| FULL TEXT
Fluoroquinolone and fortified antibiotics for treating bacterial corneal ulcers
Gangopadhyay et al.
Br. J. Ophthalmol. 2000;84:378-384.
ABSTRACT
| FULL TEXT
Risk factors for treatment outcome of suspected microbial keratitis
Morlet et al.
Br. J. Ophthalmol. 1999;83:1027-1031.
ABSTRACT
| FULL TEXT
Scleral Buckle Infection With Ciprofloxacin-Resistant Pseudomonas aeruginosa
Chaudhry et al.
Arch Ophthalmol 1998;116:1251-1251.
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