Anti-inflammatory therapy and outcome in a guinea pig model of Pseudomonas keratitis.
Corneal scarring as a consequence of bacterial keratitis is an important cause of visual loss and a major indication for penetrating keratoplasty. Anti-inflammatory agents might be useful in this condition for limiting corneal damage, but benefit from adjunctive anti-inflammatory therapy has never been demonstrated. In this limited pilot study, we compared the effect on clinical outcome of treating Pseudomonas keratitis in guinea pigs with prednisolone (a corticosteroid), flurbiprofen (a cyclo-oxygenase inhibitor), nordihydroguaiaretic acid (a lipoxygenase inhibitor), and a leukotriene antagonist, SKF104353 [R-(R*, S*)]-beta-[(2-carboxyethyl) thio-alpha-hydroxy-2-(8-phenyloctyl) benzenepropanoic acid, zinc salt]. None of the anti-inflammatory agents prevented sterilization of ulcers with antibiotic (ofloxacin) therapy. Therapy with the leukotriene antagonist appeared to reduce infiltrate size more quickly and produce a more rapid reduction in lesion size, but the differences were not statistically significant. Sample size calculations suggest that very large numbers of animals would be required to prove efficacy. The role of anti-inflammatory agents in reducing the stromal destruction caused by bacterial keratitis remains controversial.
Ohadi
C
C
Doheny Eye Institute, Los Angeles, CA 90033.
Litwin
K L
KL
Moreira
H
H
Kwitko
S
S
Gauderman
W J
WJ
Gritz
D C
DC
Gwon
A
A
Jones
R
R
McDonnell
P J
PJ
D000704:Analysis of Variance; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003998:Dicarboxylic Acids / Q000627:therapeutic use; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000188:drug therapy*; D005480:Flurbiprofen / Q000627:therapeutic use; D006168:Guinea Pigs; D007634:Keratitis / Q000188:drug therapy* / Q000382:microbiology; D009637:Masoprocol / Q000627:therapeutic use; D015242:Ofloxacin / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use*; D011552:Pseudomonas Infections / Q000188:drug therapy*; D011897:Random Allocation; D013189:SRS-A / Q000037:antagonists & inhibitors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D003998:Dicarboxylic Acids; D013189:SRS-A; D005480:Flurbiprofen; D009637:Masoprocol; D011239:Prednisolone; D015242:Ofloxacin; C052393:pobilukast