title: Initial treatment of microbial keratitis.
abstract: OBJECTIVE
  The common occurrence of failed medical treatment in microbial keratitis led us to investigate this phenomenon.
  
  
  METHODS
  We retrospectively reviewed all ulcers that presented to our department for 24 consecutive months. We classified each ulcer as either a therapeutic success or failure based on a precise definition of the response to initial antibiotic selection. We then analyzed multiple factors including: antibiotic selection, ophthalmic disease, ulcer characteristics, and management, to determine their significance in the success or failure in treating microbial keratitis. Complications were also examined.
  
  
  RESULTS
  Important factors in failure were non-fortified antibiotics (P < 0.001), ocular surface disease (P = 0.0178) and outpatient management (P < 0.001). Large ulcers (P = 0.051) were of borderline significance. Sensitivity results reflect high sensitivity among successfully treated patients when appropriate antibiotics are chosen.
  
  
  CONCLUSIONS
  This report provides insight into current practice patterns and potential means to improve success in managing microbial keratitis.
authors.affiliation: Cornea Department, Wills Eye Hospital, Philadelphia, PA, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Blanton
authors.forename: C J
authors.initials: CJ
authors.lastname: Rapuano
authors.forename: E J
authors.initials: EJ
authors.lastname: Cohen
authors.forename: P R
authors.initials: PR
authors.lastname: Laibson
mesh_terms: D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003261:Contact Lenses / Q000009:adverse effects; D003320:Corneal Ulcer / Q000209:etiology / Q000628:therapy; D006801:Humans; D007239:Infections; D007634:Keratitis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents