title: Oral moxifloxacin and topical amikacin for Mycobacterium abscessus keratitis after laser in situ keratomileusis.
abstract: We report a case of Mycobacterium abscessus keratitis after elective laser in situ keratomileusis in a 19-year-old woman. The infection started 3 weeks after uneventful surgery, and the patient received multiple antimicrobial treatments without response. A corneal scrape isolate showed an acid-fast bacterium that was subsequently confirmed by culture to be M abscessus. Prompt treatment of oral moxifloxacin 400 mg twice daily and hourly topical amikacin 2.5% was started. Recovery occurred within the first week of treatment, with complete resolution 3 weeks after presentation. The final uncorrected distance visual acuity was 6/9. We comment on other reports of post-LASIK keratitis caused by M abscessus, the in vitro sensitivity to antibiotic agents described in the literature, and the use of oral moxifloxacin as a potential good alternative treatment based on its good ocular bioavailability, which in our case allowed resolution without the need for surgical intervention.
authors.affiliation: Department of Clinical Ophthalmology, Moorfields Eye Hospital, London, United Kingdom. patricio.pacheco@moorfields.nhs.uk
authors.forename: Patricio A
authors.initials: PA
authors.lastname: Pacheco
authors.forename: Patrick M K
authors.initials: PM
authors.lastname: Tam
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000583:Amikacin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001372:Aza Compounds / Q000008:administration & dosage; D003320:Corneal Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D000077266:Moxifloxacin; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D011183:Postoperative Complications; D011804:Quinolines / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000583:Amikacin; D000077266:Moxifloxacin