Comparison of antibiotic-only and antibiotic-steroid combination treatment in corneal ulcer patients: double-blinded randomized clinical trial

New Insights Into Infectious Keratitis

“…Results from these studies indicated that steroid use in bacterial ulcers lead to similar visual outcome, [20][21][22] complication rates, 20 and infiltrate/scar size 21 as compared with antibiotic use alone. Although 1 author noticed no difference in epithelial healing rates between the 2 groups during 18 months of followup, 5 others concluded that the steroid with antibiotic group healed slower than the antibiotic only group.…”

“…Although 1 author noticed no difference in epithelial healing rates between the 2 groups during 18 months of followup, 5 others concluded that the steroid with antibiotic group healed slower than the antibiotic only group. 21,22 Very recently, a large randomized, double-masked multicenter clinical trial has been performed as the Steroids for Corneal Ulcers Trial. 23 In this trial, 500 patients with culturepositive bacterial corneal ulcer received either prednisolone sodium phosphate 1.0% or placebo after being treated with topical moxifloxacin for at least 48 hours before randomization.…”

Levofloxacin and Tobramycin for Severe Bacterial Keratouveitis

“…44 Sy et al observed that Pseudomonas aeruginosa corneal ulcers have a more severe presentation but they show a better response to antibiotic treatment than other bacterial ulcers, without any significant benefits in visual outcome, infiltrate/scar size, and incidence of adverse events related to a treatment with topical steroids. 46 However, an antibiotic-steroid combination treatment does not seem to be harmful when employed in a closely monitored clinical setting and it may be helpful in reducing ulcer size. 46 In our study 60% of cases were treated with tobramycin and dexamethasone eyedrops after epithelial healing and in order to reduce corneal opacities, but this did not lead to a significant improvement in visual prognosis.…”

“…46 However, an antibiotic-steroid combination treatment does not seem to be harmful when employed in a closely monitored clinical setting and it may be helpful in reducing ulcer size. 46 In our study 60% of cases were treated with tobramycin and dexamethasone eyedrops after epithelial healing and in order to reduce corneal opacities, but this did not lead to a significant improvement in visual prognosis.…”

Pharmacological treatment for infectious corneal ulcers

“…Prolonged use can lead to super infections and increased stromal melt. Blair et al found no benefit of a steroid/antibiotic combination (gatifloxacin and dexamethasome 0.1%) compared with gatifloxacin alone in the early treatment of patients with culture-proven bacteria corneal ulcers [107].…”