Community opinions in the management of corneal ulcers and ophthalmic antibiotics: a survey of 4 states.
OBJECTIVE
To evaluate the ophthalmic community's current opinions of the management of bacterial keratitis and usage of the currently available ophthalmic antibiotics.


METHODS
An anonymous questionnaire was mailed to ophthalmologists in California, Florida, Illinois, and Missouri. The results were tabulated and analyzed statistically.


RESULTS
Six hundred twenty-nine usable questionnaires (10.3%) were returned. In the management of corneal ulcers, 42.2% of comprehensive ophthalmologists and 75.3% of cornea specialists perform Gram stains some of the time. A total of 73.3% of comprehensive ophthalmologists and 93.7% of cornea specialists perform corneal cultures some of the time. A total of 88.8% of comprehensive ophthalmologists and 76% of cornea specialists initiate treatment with the newer fluoroquinolone antibiotics. A total of 12.1% of comprehensive ophthalmologists and 41% of cornea specialists would select fortified antibiotics for the treatment of corneal ulcers. The percentage of those who feel that fortified antibiotics are superior ranges from 17.7% for comprehensive ophthalmologists to 33.3% for cornea specialists. A total of 65.7% of comprehensive ophthalmologists indicate that the newer fluoroquinolones have impacted their practices, and 58.3% indicate that they represent an improvement over older fluoroquinolones.


CONCLUSIONS
Most responding ophthalmologists initiate empiric therapy with the newer fluoroquinolone antibiotics for corneal ulcers, forgoing Gram staining and culturing. However, respondents are not universally sanguine about the newer fluoroquinolones. The practice patterns and opinions on antibiotics differ almost universally between comprehensive ophthalmologists and cornea specialists. Larger, more detailed surveys and more specific analyses would help to further establish the factors that lead to differing management choices and opinions.
Hsu
Hugo Y
HY
Department of Ophthalmology, Saint Louis University School of Medicine, Saint Louis, MO 63104, USA. hsuhy@slu.edu
Nacke
Randall
R
Song
Jonathan C
JC
Yoo
Sonia H
SH
Alfonso
Eduardo C
EC
Israel
Heidi A
HA
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002140:California / Q000453:epidemiology; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D005431:Florida / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D008923:Missouri / Q000453:epidemiology; D009883:Ophthalmic Solutions; D015995:Prevalence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D009883:Ophthalmic Solutions