December 27, 2013
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Topical antibiotics treat smaller corneal grafts infected with multi-drug resistant Pseudomonas aeruginosa

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Corneal grafts infected with multi-drug resistant Pseudomonas aeruginosa were more successfully treated with topical antibiotics when the corneal graft infiltrate was small, according to a study.

Of 38 patients with multi-drug resistant Pseudomonas aeruginosa infection, 31 were initially treated with combined cefazolin 5% and ciprofloxacin 0.3%, six were initially treated with colistin 0.19%, and one patient was initially treated with impenem 1%. After 2 weeks, infection resolved in nine patients and partially resolved in six.

Repeat graft was required in 22 patients and one eye was eviscerated, the researchers reported in the restrospective review.
Those with successful treatment had smaller corneal graft infiltrates, median area of 2 mm2, whereas graft infiltrates were 24.8 mm2 in those that failed (P = .02).

“The use of topical colistin can be tried in patients with sensitive and smaller infiltrates, but the larger infiltrates and those with endophthalmitis often required surgical intervention,” the study authors said.

Disclosure: The authors report no relevant financial disclosures.