Comparison of topical 0.3% ofloxacin to fortified tobramycin-cefazolin in the therapy of bacterial keratitis.
BACKGROUND
In this study we compared topical ofloxacin with a combination of fortified tobramycin sulphate and cefazolin sodium solutions in the treatment of culture-proved bacterial keratitis.


METHODS
30 eyes of culture-proved bacterial corneal ulcers of moderate severity were included in a prospective randomized, controlled, double-masked study for comparison. The cases were randomly allocated to treatment with 0.3% ofloxacin solution (Group I) and combination of fortified antibiotics (1.5% tobramycin and 5% cefazolin solutions--Group II as control) along with supportive cycloplegic, vitamins and antiglaucoma therapy. Time for healing of ulcer and subjective symptoms were main outcome measures. 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% in the treated and the control group, respectively. The mean duration of symptomatic relief was 7.8 +/- 1.54 days in the treated group and 8.33 +/- 1.44 days in the control group; for epithelial healing it was 15.0 +/- 3.86 days in the treated group and 15.46 +/- 3.86 days in the control group. Post resolution the best corrected visual acuity of 20/200 or better was achieved in all but one eye each in both groups.


CONCLUSIONS
Both ofloxacin 0.3% and combined fortified tobramycin 1.5% and cefazolin 5% topical drops were comparable for treating cases of bacterial corneal ulcer of moderate severity. However, considering the easy availability and cost effectiveness of ofloxacin, a monotherapy with ofloxacin may be preferred over the combined, fortified tobramycin and cefazolin therapy.
Khokhar
S
S
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi. khokhar@medinst.ernet.in
Sindhu
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N
Mirdha
B R
BR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002437:Cefazolin / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D003320:Corneal Ulcer / Q000188:drug therapy / Q000382:microbiology; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007634:Keratitis / Q000188:drug therapy* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000191:economics / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus; D013997:Time Factors; D014031:Tobramycin / Q000627:therapeutic use; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D002511:Cephalosporins; D009883:Ophthalmic Solutions; D015242:Ofloxacin; D002437:Cefazolin; D014031:Tobramycin