title: Intracanalicular antibiotics may obviate the need for surgical management of chronic suppurative canaliculitis.
abstract: Chronic suppurative lacrimal canaliculitis is an important cause of ocular surface discomfort. Treatment with topical antibiotics is often inadequate and surgical treatment by canaliculotomy and canalicular curettage has been the mainstay of treatment in the past. The role of canalicular antibiotic irrigation has been inadequately studied. We report the clinical features, microbiological profile and treatment outcome in a series of 12 patients with suppurative lacrimal canaliculitis. Two patients had Actinomyces infection, five had Nocardia infection and seven patients had polymicrobial infection. Three patients had resolution of canaliculitis on combination broad-spectrum topical antibiotic therapy using ciprofloxacin and fortified cefazolin. In nine patients, topical antibiotic therapy was combined with canalicular irrigation using fortified cefazolin. All patients had excellent resolution of canaliculitis without the need for surgical treatment. Availability of broad-spectrum antibiotics and canalicular irrigation may offer an alternative to surgery in the management of suppurative lacrimal canaliculitis.
authors.affiliation: Medical and Vision Research Foundation, Chennai, Tamil Nadu, India. drerm@snmail.org
authors.forename: E Ravindra
authors.initials: ER
authors.lastname: Mohan
authors.forename: Sachin
authors.initials: S
authors.lastname: Kabra
authors.forename: Priti
authors.initials: P
authors.lastname: Udhay
authors.forename: H N
authors.initials: HN
authors.lastname: Madhavan
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001419:Bacteria / Q000302:isolation & purification; D002437:Cefazolin / Q000627:therapeutic use*; D002908:Chronic Disease; D002939:Ciprofloxacin / Q000627:therapeutic use*; D003607:Dacryocystitis / Q000188:drug therapy* / Q000382:microbiology; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D009883:Ophthalmic Solutions; D002939:Ciprofloxacin; D002437:Cefazolin