Combination intravenous ceftazidime and aminoglycosides in the treatment of pseudomonal scleritis.
BACKGROUND
Pseudomonal scleritis is a serious and potentially blinding infection that usually is resistant to medical management.


METHODS
Results for three patients with pseudomonal scleritis who were treated with both topical anti-infectives and a combination of intravenous ceftazidime and aminoglycoside are presented in this case series.


RESULTS
All three patients had a rapid response to the addition of combination intravenous drug therapy to topical therapy; eradication of the infection and healing of the ocular surface occurred within 8 weeks. Only one patient, in whom cystoid macular edema developed, lost useful vision as a result of the infection.


CONCLUSIONS
Combination therapy with intravenous ceftazidime and aminoglycoside may be more effective than single-intravenous agents when used in addition to topical antibiotics and may obviate the need for adjunctive surgical procedures, such ascryotherapy, surgical extirpation, or conjunctival recession.
Helm
C J
CJ
UCLA Ocular Inflammatory Disease Center, Jules Stein Eye Institute, UCLA 90095-7003, USA.
Holland
G N
GN
Webster
R G
RG
Maloney
R K
RK
Mondino
B J
BJ
D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000617:Aminoglycosides / Q000008:administration & dosage* / Q000627:therapeutic use; D002442:Ceftazidime / Q000008:administration & dosage* / Q000627:therapeutic use; D002511:Cephalosporins / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012590:Sclera / Q000382:microbiology / Q000473:pathology; D015423:Scleritis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D014792:Visual Acuity
D000617:Aminoglycosides; D002511:Cephalosporins; D009883:Ophthalmic Solutions; D002442:Ceftazidime