A Review of the Categorizations of Mild, Moderate, and Severe Bacterial Keratitis Ulcers and Day-1 Treatment Regimen When Using the Topical Fluoroquinolones 0.3% Ciprofloxacin and 0.3% Ofloxacin
ABSTRACT: Background: There are published suggestions that bacterial keratitis (BK) can be classified as mild, moderate, or severe and that the day-1 antibiotic drop regimen may differ for each category using the topical second-generation fluoroquinolones 0.3% ciprofloxacin and 0.3% ofloxacin (2FQ)...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Current Therapeutic Research |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0011393X23000383 |
| _version_ | 1827591724159991808 |
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| author | John Graham Pearce, PhD Ozge Sarac, MD Ted Maddess, PhD |
| author_facet | John Graham Pearce, PhD Ozge Sarac, MD Ted Maddess, PhD |
| author_sort | John Graham Pearce, PhD |
| collection | DOAJ |
| description | ABSTRACT: Background: There are published suggestions that bacterial keratitis (BK) can be classified as mild, moderate, or severe and that the day-1 antibiotic drop regimen may differ for each category using the topical second-generation fluoroquinolones 0.3% ciprofloxacin and 0.3% ofloxacin (2FQ). The classification criteria are not consistently defined and the suggested regimens are often unreferenced and so here, the evidence base for applying such regimens in clinical practice is examined. Objective: To examine the evidence base regarding the categorization criteria used for BK and determine whether any evidence exists to support suggestions that different day-1 treatment regimen using the 2FQ may be applied based on any assigned categorization. Methods: The literature on BK treatment was reviewed, as were the clinical studies involving the commercially available 2FQ. All statements pertaining to classification and treatment paradigms involving BK were then collated and reviewed, as were the methodologies employed in the 2FQ clinical studies. Results: There have been no clinical trials using the 2FQ, or indeed any other topical antibiotics, which have used different day-1 drop regimen depending on the size, depth, and location of the ulcer or for ulcers classified as mild, moderate, or severe. Thus, there is no evidence to support the suggestion that a lower number of drops on day 1 is as effective as a higher number on categorized BK ulcers. Conclusions: No standardized method of categorizing BK was found, and there is no evidence to support the contention that mild, moderate, or smaller BK ulcers should be treated any differently to larger or severe ulcers on day 1. The manufacturers of 2FQ do not supply different treatment regimens for different ulcer sizes and severity categories. When using the 2FQ, all BK ulcers should be treated equally in line with the manufacturers’ recommended day-1 treatment regimen. |
| first_indexed | 2024-03-09T01:36:44Z |
| format | Article |
| id | doaj.art-fb3dc6e184684679add295a48d8ed44f |
| institution | Directory Open Access Journal |
| issn | 0011-393X |
| language | English |
| last_indexed | 2024-03-09T01:36:44Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Current Therapeutic Research |
| spelling | doaj.art-fb3dc6e184684679add295a48d8ed44f2023-12-09T06:04:12ZengElsevierCurrent Therapeutic Research0011-393X2023-01-0199100729A Review of the Categorizations of Mild, Moderate, and Severe Bacterial Keratitis Ulcers and Day-1 Treatment Regimen When Using the Topical Fluoroquinolones 0.3% Ciprofloxacin and 0.3% OfloxacinJohn Graham Pearce, PhD0Ozge Sarac, MD1Ted Maddess, PhD2John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia; Address correspondence to: John Graham Pearce, PhD, John Curtin School of Medical Research, Australian National University, 131 Garran Rd, Acton, 2601, Canberra, ACT, Australia.Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara, Turkey; Wills Eye Hospital, Philadelphia, Pennsylvania, United States of AmericaJohn Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, AustraliaABSTRACT: Background: There are published suggestions that bacterial keratitis (BK) can be classified as mild, moderate, or severe and that the day-1 antibiotic drop regimen may differ for each category using the topical second-generation fluoroquinolones 0.3% ciprofloxacin and 0.3% ofloxacin (2FQ). The classification criteria are not consistently defined and the suggested regimens are often unreferenced and so here, the evidence base for applying such regimens in clinical practice is examined. Objective: To examine the evidence base regarding the categorization criteria used for BK and determine whether any evidence exists to support suggestions that different day-1 treatment regimen using the 2FQ may be applied based on any assigned categorization. Methods: The literature on BK treatment was reviewed, as were the clinical studies involving the commercially available 2FQ. All statements pertaining to classification and treatment paradigms involving BK were then collated and reviewed, as were the methodologies employed in the 2FQ clinical studies. Results: There have been no clinical trials using the 2FQ, or indeed any other topical antibiotics, which have used different day-1 drop regimen depending on the size, depth, and location of the ulcer or for ulcers classified as mild, moderate, or severe. Thus, there is no evidence to support the suggestion that a lower number of drops on day 1 is as effective as a higher number on categorized BK ulcers. Conclusions: No standardized method of categorizing BK was found, and there is no evidence to support the contention that mild, moderate, or smaller BK ulcers should be treated any differently to larger or severe ulcers on day 1. The manufacturers of 2FQ do not supply different treatment regimens for different ulcer sizes and severity categories. When using the 2FQ, all BK ulcers should be treated equally in line with the manufacturers’ recommended day-1 treatment regimen.http://www.sciencedirect.com/science/article/pii/S0011393X230003830.3% ciprofloxacin0.3% ofloxacinBacterial keratitis categorizationDay-1 treatment regimenUlcer locationUlcer size |
| spellingShingle | John Graham Pearce, PhD Ozge Sarac, MD Ted Maddess, PhD A Review of the Categorizations of Mild, Moderate, and Severe Bacterial Keratitis Ulcers and Day-1 Treatment Regimen When Using the Topical Fluoroquinolones 0.3% Ciprofloxacin and 0.3% Ofloxacin Current Therapeutic Research 0.3% ciprofloxacin 0.3% ofloxacin Bacterial keratitis categorization Day-1 treatment regimen Ulcer location Ulcer size |
| title | A Review of the Categorizations of Mild, Moderate, and Severe Bacterial Keratitis Ulcers and Day-1 Treatment Regimen When Using the Topical Fluoroquinolones 0.3% Ciprofloxacin and 0.3% Ofloxacin |
| title_full | A Review of the Categorizations of Mild, Moderate, and Severe Bacterial Keratitis Ulcers and Day-1 Treatment Regimen When Using the Topical Fluoroquinolones 0.3% Ciprofloxacin and 0.3% Ofloxacin |
| title_fullStr | A Review of the Categorizations of Mild, Moderate, and Severe Bacterial Keratitis Ulcers and Day-1 Treatment Regimen When Using the Topical Fluoroquinolones 0.3% Ciprofloxacin and 0.3% Ofloxacin |
| title_full_unstemmed | A Review of the Categorizations of Mild, Moderate, and Severe Bacterial Keratitis Ulcers and Day-1 Treatment Regimen When Using the Topical Fluoroquinolones 0.3% Ciprofloxacin and 0.3% Ofloxacin |
| title_short | A Review of the Categorizations of Mild, Moderate, and Severe Bacterial Keratitis Ulcers and Day-1 Treatment Regimen When Using the Topical Fluoroquinolones 0.3% Ciprofloxacin and 0.3% Ofloxacin |
| title_sort | review of the categorizations of mild moderate and severe bacterial keratitis ulcers and day 1 treatment regimen when using the topical fluoroquinolones 0 3 ciprofloxacin and 0 3 ofloxacin |
| topic | 0.3% ciprofloxacin 0.3% ofloxacin Bacterial keratitis categorization Day-1 treatment regimen Ulcer location Ulcer size |
| url | http://www.sciencedirect.com/science/article/pii/S0011393X23000383 |
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