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Elmer Tu, Sandeep Jain; Topical Linezolid 0.2% for the Treatment of Gram Positive Bacterial Keratitis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2899.
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To report the clinical efficacy of topical linezolid for the treatment of vancomycin-resistant of -intolerant gram positive keratitis.
All cases of bacterial keratitis treated at the University of Illinois Eye and Ear Infirmary 2007 to date with topical linezolid were identified from the Cornea and External Disease Clinic and were reviewed for culture results, prior therapy, clinical course and visual outcome.
Three cases of gram positive keratitis were identified that were treated with topical linezolid. Cases consisted of one case of recalcitrant Vancomycin Resistant Enterococcus faecalis (VRE) and two cases of infectious crystalline keratitis, one culture positive for an uncharacterized Staphylococcus and the other for Streptococcus mitis. All three patients had rapid resolution of their primary gram positive keratitis and noted no pain associated with topical therapy, but the VRE keratitis developed a new Candida keratitis elsewhere in the same cornea at the end of therapy.
Topical linezolid 0.2% can be an effective compounded antibiotic for the treatment of gram positive keratitis, including VRE, and is both significantly more comfortable and less immediately toxic to the ocular surface than topical vancomycin.
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