May 2006
Volume 47, Issue 13
ARVO Annual Meeting Abstract  |   May 2006
Effects of Antimicrobial Resistance on Current Bacterial Keratitis Treatment Practices
Author Affiliations & Notes
  • A. Parikh
    Brown Medical School, Providence, RI
  • K.L. Anderson
    Brown Medical School, Providence, RI
    Dept of Ophthalmology, Rhode Island Hospital, Providence, RI
  • Footnotes
    Commercial Relationships  A. Parikh, None; K.L. Anderson, None.
  • Footnotes
    Support  Brown University: Summer Research Assistantship
Investigative Ophthalmology & Visual Science May 2006, Vol.47, 3564. doi:
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      A. Parikh, K.L. Anderson; Effects of Antimicrobial Resistance on Current Bacterial Keratitis Treatment Practices . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3564.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : To evaluate current practices in the treatment of bacterial keratitis in the context of current clinical and microbiological characteristics at Rhode Island Hospital in the past 5 years.

Methods: : As a retrospective chart review, this study analyzed patients clinically diagnosed with bacterial keratitis presenting at Rhode Island Hospital between January, 2000 and January, 2005. Patients were identified by medical record and microbiology report searches for the diagnosis of bacterial keratitis. Etiology, causative organisms, antimicrobial susceptibility, initial treatment before culture susceptibility results, therapy modification after susceptibility results, and outcomes were analyzed.

Results: : Bacterial keratitis was diagnosed in 46 patients (22 male, 24 female; mean age, 49.4 years). The most common risk factors for bacterial keratitis were contact–lens wear (26.1%), trauma/foreign body in eye (23.9%), and exposure keratopathy (17.4%). Coagulase negative Staphylococcus was the most commonly isolated organism (45.0%), followed by Pseudomonas aeruginosa (10.0%). Ofloxacin (42.2%), Ciprofloxacin (28.0%), and Gatifloxacin (20%) were the most common fluoroquinolones used in initial treatment. Cefazolin (42.2%) and Tobramycin (35.6%) were the most common fortified antibiotics used in initial treatment. Sensitivity of cultures with coagulase negative Staphylococcus isolates was 50% sensitive to Cefazolin and 72.7% sensitive to Ciprofloxacin. The initial treatment of 55.6% of the cases was modified after culture results. Resistance to initial treatment was the most common reason for modifying treatment and accounted for 56.0% (n=14) of cases with modified treatment. There were no significant differences (p>0.05; Z test) between patients with resistance and patients with no resistance to initial therapy for outcomes of loss of vision (p=0.15), evisceration of eye (p=0.602), corneal transplant (p=0.642), and non–healing corneal ulcers (p=0.322).

Conclusions: : Antimicrobial resistance is a key factor in the course of therapy for patients with bacterial keratitis. Current resistance patterns of causative organisms are vital for rapid, effective therapy.

Keywords: keratitis • microbial pathogenesis: clinical studies • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials 

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