Trends in Resistance to Ciprofloxacin, Cefazolin, and Gentamicin in the Treatment of Bacterial Keratitis

Abstract

There was increased resistance of gram-positive organisms to ciprofloxacin and cefazolin, but not gentamicin, in the two examined time periods. Increased resistance to these commonly used antibiotics emphasizes the need for close follow-up after initial empiric treatment, and maintaining a low threshold for selecting alternative therapy.

Corneal Ulcer: Analysis of Isolated Bacteria and Antibiotics Sensitivity in the Urban Region of Attica, Greece

“…The fact that newer antibiotics as Quinolones became resistant, confirms that topical instillation may lead to resistancy. This makes treatment even more challenging, and leads pharmaceutical companies to the discovery of newer and more aggressive antibiotics [11,12,19]. The antibiograms of the current study confirm that bacterial sensitivity is really limited to the frequently used antibiotics.…”

“…The main questions that arise directly after the diagnosis of a corneal ulcer are the nature of the responsible bacteria and the appropriate treatment to be administered. According to guidelines, for a corneal ulcer culture, the diameter of the lesion needs to be > 2 mm to have a positive culture in 52.5%-73% [1,[5][6][7][11][12][13][14][15]. In our study contrariwise to previous studies, cultures were taken in every patient presented to the emergencies with a corneal ulcer, regardless of the size of the lesion or whether the patient was already under treatment or not and this is the only limitation of our study.…”

“…Previous studies regarding Quinolones and Amino glycosides show diversity. Afshari et al [11] report increased resistance in Quinolones but not in Gentamycin while in the paper of Azevedo Gayoso et al [19] there is a clear decrease of in vitro sensitivity in Methicilline, Tobramycin and Gentamycin whereas it remains stable in Ofloxacine and Ciprofloxacin. In contact lens users P aeruginosa was the most frequently isolated Gram negative strain.…”

“…The initial therapy usually requires broad spectrum antibiotics but their reckless use in everyday practice has lead either to treatment failure or to the development of resistant bacteria that make ophthalmic infection quite challenging to treat [11,12]. The correct treatment of an infectious corneal ulcer requires topical antibiotics based on the culture result.…”

“…The correct treatment of an infectious corneal ulcer requires topical antibiotics based on the culture result. Several authors describe the bacteria isolated and their resistance to the antibiotics used [1,2,4,[6][7][8][9][10][11][12]. The bacteria responsible for corneal ulcers may vary according to the patient's origin, climate, and regional conditions [9,13].…”