The Value of Fortified Aminoglycoside/Cephalosporin Treatment as First-Line Treatment and in Fluoroquinolone-Resistant Bacterial Keratitis
Objectives:Topical application of fluoroquinolone antibiotics is thought to be as effective as fortified antibiotics. The aim of this study was to evaluate the efficacy of fluoroquinolones as an alternative to fortified antibiotic therapies.Materials and Methods:The medical records of 31 patients wh...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Galenos Yayinevi
2020-10-01
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| Series: | Türk Oftalmoloji Dergisi |
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http://www.oftalmoloji.org/archives/archive-detail/article-preview/the-value-of-fortified-aminoglycoside-cephalospori/41728
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| _version_ | 1797907311157575680 |
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| author | Özlem Dikmetaş Yağmur Deniz Sibel Kocabeyoğlu Merve Başol Murat İrkeç |
| author_facet | Özlem Dikmetaş Yağmur Deniz Sibel Kocabeyoğlu Merve Başol Murat İrkeç |
| author_sort | Özlem Dikmetaş |
| collection | DOAJ |
| description | Objectives:Topical application of fluoroquinolone antibiotics is thought to be as effective as fortified antibiotics. The aim of this study was to evaluate the efficacy of fluoroquinolones as an alternative to fortified antibiotic therapies.Materials and Methods:The medical records of 31 patients who were hospitalized in our department due to bacterial keratitis were retrospectively reviewed. Fluoroquinolone was started as the first treatment for 20 (64.5%) patients and upon no response fortified antibiotic was initiated, and 11 (35.5%) patients were started with fortified treatment. Cultures and smears were recorded before treatment. Lesions were evaluated as superficial or deep according to their depth. Treatment response was evaluated based on reduction of infiltrate depth and size, change in visual acuity, and regression of hypopyon.Results:Central, paracentral, and peripheral location were detected in 9 (29.0%), 10 (32.2%) and 12 (38.7%) eyes, respectively. According to lesion depth, 15 (48.3%) were deep and 16 (51.6%) were superficial. Response of superficial lesions was found to be statistically earlier (p=0.037). Culture was positive in 9 (29.0%) eyes. The initial best corrected visual acuity (BCVA) was 0.5±0.7 logMAR (-0.1-2.3) and 0.3±0.3 logMAR (-0.1-0.9) after treatment. Treatment response showed moderate but statistically nonsignificant correlation with time to treatment initiation and initial BCVA (r=0.527, p=0.184; r=0.517, p=0.120).Conclusion:Although fluoroquinolones are the first choice for the treatment of bacterial keratitis, fortified antibiotics have been shown to be effective in patients who do not respond to treatment. Fortified therapy should be kept in mind in the treatment of bacterial keratitis. |
| first_indexed | 2024-04-10T10:34:33Z |
| format | Article |
| id | doaj.art-7ea061b0b3d2442b9a1c1556c3a9ab20 |
| institution | Directory Open Access Journal |
| issn | 1300-0659 2147-2661 |
| language | English |
| last_indexed | 2024-04-10T10:34:33Z |
| publishDate | 2020-10-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Türk Oftalmoloji Dergisi |
| spelling | doaj.art-7ea061b0b3d2442b9a1c1556c3a9ab202023-02-15T16:20:55ZengGalenos YayineviTürk Oftalmoloji Dergisi1300-06592147-26612020-10-0150525826310.4274/tjo.galenos.2020.3734613049054The Value of Fortified Aminoglycoside/Cephalosporin Treatment as First-Line Treatment and in Fluoroquinolone-Resistant Bacterial KeratitisÖzlem Dikmetaş0Yağmur Deniz1Sibel Kocabeyoğlu2Merve Başol3Murat İrkeç4 Hacettepe Üniversitesi Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, Ankara, Türkiye Hacettepe Üniversitesi Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, Ankara, Türkiye Hacettepe Üniversitesi Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, Ankara, Türkiye Hacettepe Üniversitesi Tıp Fakültesi, Biyoistatistik Anabilim Dalı, Ankara, Türkiye Hacettepe Üniversitesi Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, Ankara, Türkiye Objectives:Topical application of fluoroquinolone antibiotics is thought to be as effective as fortified antibiotics. The aim of this study was to evaluate the efficacy of fluoroquinolones as an alternative to fortified antibiotic therapies.Materials and Methods:The medical records of 31 patients who were hospitalized in our department due to bacterial keratitis were retrospectively reviewed. Fluoroquinolone was started as the first treatment for 20 (64.5%) patients and upon no response fortified antibiotic was initiated, and 11 (35.5%) patients were started with fortified treatment. Cultures and smears were recorded before treatment. Lesions were evaluated as superficial or deep according to their depth. Treatment response was evaluated based on reduction of infiltrate depth and size, change in visual acuity, and regression of hypopyon.Results:Central, paracentral, and peripheral location were detected in 9 (29.0%), 10 (32.2%) and 12 (38.7%) eyes, respectively. According to lesion depth, 15 (48.3%) were deep and 16 (51.6%) were superficial. Response of superficial lesions was found to be statistically earlier (p=0.037). Culture was positive in 9 (29.0%) eyes. The initial best corrected visual acuity (BCVA) was 0.5±0.7 logMAR (-0.1-2.3) and 0.3±0.3 logMAR (-0.1-0.9) after treatment. Treatment response showed moderate but statistically nonsignificant correlation with time to treatment initiation and initial BCVA (r=0.527, p=0.184; r=0.517, p=0.120).Conclusion:Although fluoroquinolones are the first choice for the treatment of bacterial keratitis, fortified antibiotics have been shown to be effective in patients who do not respond to treatment. Fortified therapy should be kept in mind in the treatment of bacterial keratitis. http://www.oftalmoloji.org/archives/archive-detail/article-preview/the-value-of-fortified-aminoglycoside-cephalospori/41728 bacterial keratitistopical treatmentfortified antibiotics |
| spellingShingle | Özlem Dikmetaş Yağmur Deniz Sibel Kocabeyoğlu Merve Başol Murat İrkeç The Value of Fortified Aminoglycoside/Cephalosporin Treatment as First-Line Treatment and in Fluoroquinolone-Resistant Bacterial Keratitis Türk Oftalmoloji Dergisi bacterial keratitis topical treatment fortified antibiotics |
| title | The Value of Fortified Aminoglycoside/Cephalosporin Treatment as First-Line Treatment and in Fluoroquinolone-Resistant Bacterial Keratitis |
| title_full | The Value of Fortified Aminoglycoside/Cephalosporin Treatment as First-Line Treatment and in Fluoroquinolone-Resistant Bacterial Keratitis |
| title_fullStr | The Value of Fortified Aminoglycoside/Cephalosporin Treatment as First-Line Treatment and in Fluoroquinolone-Resistant Bacterial Keratitis |
| title_full_unstemmed | The Value of Fortified Aminoglycoside/Cephalosporin Treatment as First-Line Treatment and in Fluoroquinolone-Resistant Bacterial Keratitis |
| title_short | The Value of Fortified Aminoglycoside/Cephalosporin Treatment as First-Line Treatment and in Fluoroquinolone-Resistant Bacterial Keratitis |
| title_sort | value of fortified aminoglycoside cephalosporin treatment as first line treatment and in fluoroquinolone resistant bacterial keratitis |
| topic | bacterial keratitis topical treatment fortified antibiotics |
| url |
http://www.oftalmoloji.org/archives/archive-detail/article-preview/the-value-of-fortified-aminoglycoside-cephalospori/41728
|
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