This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Plea for Data

Peter J. McDonnell, MD

Arch Ophthalmol. 1996;114(1):84-87.

Abstract
In the United States, about 30 000 bacterial corneal ulcers are treated annually.¹ Compared with 100, or even 20, years ago ophthalmologists today have available to them many diagnostic tools (including special media and bacterial identification techniques), and an impressive assortment of antibiotics.^2-4 Many reviews and book chapters describe the uses of microbiologic studies—from Gram and Giemsa staining to media inoculation to immunofluorescence and even molecular genetics—to identify causative organisms. This literature also describes the formulas for preparation of highly concentrated, "fortified" antibiotics for initial treatment of bacterial keratitis, until culture and sensitivity results are available to guide modifications in therapy. It would seem, therefore, that "experts" in the field of corneal and external diseases have reached consensus on an appropriate initial microbiologic evaluation and treatment of suspected microbial keratitis, and the large body of literature on this topic might be considered to represent practice guidelines. It comes as a surprise to many that these published "guidelines" apparently are routinely ignored in current clinical practice.

Author Affiliations
From the Department of Ophthalmology, Doheny Eye Institute, Los Angeles, Calif.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Bacterial Susceptibility to Topical Antimicrobials and Clinical Outcome in Bacterial Keratitis
Kaye et al.
IOVS 2010;51:362-368.
ABSTRACT | FULL TEXT  

Rationale for Adjunctive Topical Corticosteroids in Bacterial Keratitis
Hindman et al.
Arch Ophthalmol 2009;127:97-102.
FULL TEXT  

Initial therapy for suppurative microbial keratitis in Iraq
Al-Shakarchi
Br J Ophthalmol 2007;91:1583-1587.
ABSTRACT | FULL TEXT  

Influence of Fluoroquinolone Susceptibility on the Therapeutic Response of Fluoroquinolone-Treated Bacterial Keratitis
Wilhelmus et al.
Arch Ophthalmol 2003;121:1229-1233.
ABSTRACT | FULL TEXT  

Severe infective keratitis leading to hospital admission in New Zealand
Wong et al.
Br J Ophthalmol 2003;87:1103-1108.
ABSTRACT | FULL TEXT  

Simplifying Collection of Corneal Specimens in Cases of Suspected Bacterial Keratitis
Kaye et al.
J. Clin. Microbiol. 2003;41:3192-3197.
ABSTRACT | FULL TEXT  

Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases
Bourcier et al.
Br J Ophthalmol 2003;87:834-838.
ABSTRACT | FULL TEXT  

Prevention of Herpes Simplex Virus Eye Disease: A Cost-effectiveness Analysis
Lairson et al.
Arch Ophthalmol 2003;121:108-112.
ABSTRACT | FULL TEXT  

Emergence of Refractive Surgery
McDonnell
Arch Ophthalmol 2000;118:1119-1120.
FULL TEXT  

Corneal ulceration in the elderly in Hyderabad, south India
Kunimoto et al.
Br J Ophthalmol 2000;84:54-59.
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  

Use of Routine Antibiotic Sensitivity Testing for the Management of Corneal Ulcers
Kowal et al.
Arch Ophthalmol 1997;115:462-465.
ABSTRACT