Fluoroquinolones in the treatment of bacterial keratitis.
OBJECTIVE
We evaluated the potential role of three topical fluoroquinolones in the treatment of bacterial keratitis by means of a laboratory database.


METHODS
Antibiotic susceptibilities were determined for 153 isolates from patients with bacterial keratitis. Results were analyzed for each fluoroquinolone individually and in combination with cefazolin.


RESULTS
Predicted susceptibility to each cefazolin-fluoroquinolone combination (98.7%) was superior to that for single-agent therapy with ofloxacin (88.2%), ciprofloxacin (82.3%), or norfloxacin (80.4%) (P = .0002). A cefazolin-fluoroquinolone combination (98.7%) was comparable to a cefazolin-gentamicin combination (97.4%).


CONCLUSIONS
Combination therapy with cefazolin and a fluoroquinolone offers a reasonable alternative for the treatment of bacterial keratitis. Single-agent therapy with fluoroquinolones for vision-threatening bacterial keratitis is not advised.
Bower
K S
KS
Department of Ophthalmology, University of Pittsburgh Medical Center, PA 15213, USA.
Kowalski
R P
RP
Gordon
Y J
YJ
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002437:Cefazolin / Q000494:pharmacology / Q000627:therapeutic use; D002511:Cephalosporins / Q000494:pharmacology / Q000627:therapeutic use; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000382:microbiology; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D024841:Fluoroquinolones; D005839:Gentamicins / Q000494:pharmacology / Q000627:therapeutic use; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008826:Microbial Sensitivity Tests; D009883:Ophthalmic Solutions
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D002511:Cephalosporins; D024841:Fluoroquinolones; D005839:Gentamicins; D009883:Ophthalmic Solutions; D002437:Cefazolin