Decision-making in the management of microbial keratitis.

Abstract:

:The successful management of suppurative microbial keratitis requires five steps: (1) make the clinical diagnosis, (2) perform the proper laboratory procedures, (3) initiate antimicrobial therapy, (4) modify the initial therapy, and (5) terminate therapy. The most helpful guidelines to decision-making in these steps are: (1) the clinical impression, (2) severity of keratitis, (3) results of laboratory studies, (4) disease potential of the responsible organism, and (5) effectiveness and toxicity of various antimicrobial agents. Selection of initial antibiotics ideally should be directed by interpretation of the corneal smears. The preferred initial antibiotic for keratitis caused by a Gram-positive coccus is cefazolin; for a Gram-negative rod, gentamicin; and for a filamentous fungi or yeast, natamycin. Broad, antibacterial therapy should be reserved for suspected bacterial keratitis with negative smears or for severe infections with antecedent treatment. Miconazole may be an effective, alternate agent in fungal keratitis. The safety and efficacy of corticosteroids in microbial keratitis have not been established.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Jones DB

doi

10.1016/s0161-6420(81)34943-4

subject

Has Abstract

pub_date

1981-08-01 00:00:00

pages

814-20

issue

8

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(81)34943-4

journal_volume

88

pub_type

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