[Effectiveness of initial antibiotic therapy for treatment of contact lens-related bacterial keratitis].
BACKGROUND
Contact lens-related microbial keratitis is a cause of potentially sight-threatening corneal opacification. Effective initial antimicrobial therapy is crucial to prevent long-term complications. This investigation was undertaken to test the effectiveness of current routine empirical antibiotic treatment regimens.


METHODS
All consecutive cases of contact lens-related keratitis presenting in the outpatient clinic of the Department of Ophthalmology at the Medical University of Innsbruck between January 2010 and April 2012 were retrospectively analyzed.


RESULTS
Cultures were positive in 69 out of the 123 cases included in the study. Culture results identified 59.4 % Gram positive strains, 50.7 % Gram negative strains and 7.2 % fungal strains. Mixed infections accounted for 29 % of cases. The combination of an aminoglycoside and a second generation quinolone antibiotic was the most common initial treatment regimen (87.8 %). In vitro this regimen was less effective compared to combinations of moxifloxacin and ciprofloxacin or moxifloxacin and gentamicin.


CONCLUSIONS
Empirical combined regimens remain an effective treatment of contact lens-related keratitis. Fluoroquinolones proved to be inadequate for monotherapy.
Universitätsklinik für Augenheilkunde und Optometrie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich, rotelotto@gmail.com.
B
B
Steger
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L
Speicher
W
W
Philipp
T
T
Gasser
E
E
Schmid
N
N
Bechrakis
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003261:Contact Lenses / Q000009:adverse effects* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000382:microbiology* / Q000473:pathology; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage*; D006801:Humans; D007634:Keratitis / Q000188:drug therapy* / Q000382:microbiology* / Q000473:pathology; D008297:Male; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000382:microbiology; D012189:Retrospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones