title: The role of cultures in the management of ulcerative keratitis.
abstract: OBJECTIVE
  To ascertain the importance of routine cultures and gram stains in the management of ulcerative keratitis.
  
  
  METHODS
  We retrospectively reviewed 119 consecutive corneal ulcers seen at Sinai Hospital of Baltimore. Cultures were obtained of the corneal ulcer and of the lids and conjunctivae of both eyes. Gram stains were performed by the hospital microbiology department on corneal scrapings from each ulcer.
  
  
  RESULTS
  Positive corneal cultures were obtained from 56 eyes (47.1%). Initial antibiotic therapy was changed based on culture results in 14.3% of culture-positive eyes that demonstrated a worsening clinical course. Gram stains were negative in all cases. The sensitivity and specificity of the lid and conjunctival cultures were determined.
  
  
  CONCLUSIONS
  Corneal cultures are important in the management of ulcerative keratitis. Lid and conjunctival cultures have low sensitivity and specificity.
authors.affiliation: Krieger Eye Institute, Sinai Hospital of Baltimore, Maryland, USA.
authors.forename: S B
authors.initials: SB
authors.lastname: Levey
authors.forename: H R
authors.initials: HR
authors.lastname: Katz
authors.forename: D A
authors.initials: DA
authors.lastname: Abrams
authors.forename: M J
authors.initials: MJ
authors.lastname: Hirschbein
authors.forename: M J
authors.initials: MJ
authors.lastname: Marsh
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003228:Conjunctiva / Q000382:microbiology; D003315:Cornea / Q000382:microbiology*; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000382:microbiology*; D005143:Eyelids / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000900:Anti-Bacterial Agents