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P. L. Goldschmidt, C. Costa Ferreira, E. Borsali, D. Benallaoua, T. Gaujoux, C. Allouch, L. Batellier, V. Borderie, L. Laroche, C. Chaumeil; Risks for Treating Bacterial Keratitis With Fluoroquinolone-Based Monotherapies. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2882.
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Visual outcome of patients presenting bacterial keratitis (bac-k) can be seriously engaged if the appropriate treatments are not administered on-time. In France, around 5000 bac-k are documented yearly, with Gram+ cocci in 50 to 90% of cases and Gram- rods in 10 to 50% according to different series. The objective of this work was to study the susceptibility of 100 strains isolated (2007-2008) at the National Eye Center in Paris (CHNO) from patients with bac-k to 3 fluoroquinolones (FQ).
Bacterial strains were isolated and tested for their susceptibilities to 3 FQ (ciprofloxacine, levofloxacine and norfloxacine) using the Kirby-Bauer disc diffusion test.
The species isolated were: 23 % negative coagulase Staphylococci (1 methicillin resistant), 17 % S. aureus (1 methicillin resistant), 12 % Streptococcus pneumoniae, 13 % S. sanguis, 19 % Pseudomonas aeruginosa, 11 % Serratia marcescens and 5 % Haemophilus influenzae. The results of the antibiotic susceptibility testing are presented hereafter
Very frequently, ophthalmologists have to decide to administrate empiric treatments before the antibiotic susceptibility testing are available. The results obtained in this survey should warn on the risks -especially for negative coagulase Staphylococci and for Streptococci- of treating bac-k with empiric monotherapies. This study confirms our previous observations suggesting that before results of antibiotic susceptibility testing are available, treatments of bac-k require at least two broad spectrum antibiotics acting each one at different molecular targets of the bacteria.
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