Comparison of topical 0.3% ofloxacin with fortified tobramycin plus cefazolin in the treatment of bacterial keratitis.
OBJECTIVE
Ofloxacin is a broad spectrum fluoroquinolone antibiotic with good ocular penetration. We compared ofloxacin 3% solution with a combination of fortified tobramycin sulphate and cefazolin sodium solutions in the treatment of culture-proven bacterial keratitis.


METHODS
Thirty eyes with culture-proven bacterial corneal ulcers were enrolled in a prospective randomised, controlled, double-masked study for comparison. The ofloxacin drop and saline were decanted into two identical-looking bottles to the tobramycin and cefazolin. The cases were randomly allocated into treatment with 0.3% ofloxacin solution or a combination of fortified antibiotics (1.5% tobramycin and 10% cefazolin solutions; control group) along with supportive cycloplegic, vitamins and anti-glaucoma therapy. Student's t-test was used to compare the results.


RESULTS
Staphylococcus aureus and coagulase-negative staphylococci were the two most common organisms isolated. Resolution of the ulcer was achieved in 93% and 87% of cases in the ofloxacin and control groups respectively. The mean time required for symptomatic relief was 7.8 +/- 1.54 days and for epithelial healing 15.0 +/- 3.86 days in ofloxacin group, compared with 8.33 +/- 1.54 days for symptomatic relief and 15.46 +/- 3.86 days for epithelial healing in the control group. Post-resolution best corrected visual acuity of 20/200 or better was achieved in all but one eye in both groups.


CONCLUSIONS
Ofloxacin and combined fortified tobramycin and cefazolin topical drops were comparable for treating cases of bacterial corneal ulcer. However, considering its easy availability and cost-effectiveness, monotherapy with ofloxacin is preferred over the combined fortified tobramycin and cefazolin therapy.
Panda
A
A
Cornea Service Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. anitap38@hotmail.com
Ahuja
R
R
Sastry
S S
SS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D002437:Cefazolin / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D003320:Corneal Ulcer / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D015818:Eye Infections, Bacterial / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage*; D009883:Ophthalmic Solutions; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy; D014031:Tobramycin / Q000627:therapeutic use; D014792:Visual Acuity / Q000187:drug effects
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D002511:Cephalosporins; D009883:Ophthalmic Solutions; D015242:Ofloxacin; D002437:Cefazolin; D014031:Tobramycin