Document Detail

Comparison of antibiotic-only and antibiotic-steroid combination treatment in corneal ulcer patients: double-blinded randomized clinical trial.
MedLine Citation:
PMID:  21283156     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the benefit of early addition of corticosteroids to antibiotics in the treatment of corneal ulcers.
DESIGN: Randomized clinical trial.
PARTICIPANTS: Thirty eyes of 30 patients, over the age of 12 years, with bacterial corneal ulcer confirmed by culture.
METHODS: Patients were randomized before enrollment; 15 were treated with gatifloxacin (Zymar) and a masked placebo and the other 15 were treated with gatifloxacin and masked dexamethasone 0.1% (Maxidex). Primary outcome was residual ulcer size at 10 weeks based on digital photographs. Secondary outcomes included residual ulcer area by clinician estimate, visual acuity, VF-14 score, and time to healing.
RESULTS: All subjects (n = 30) demonstrated a reduction in ulcer size over the study period. There was no significant difference between the 2 groups in terms of the primary outcome. There was a significant difference between the 2 groups in 1 of the secondary outcomes. The mean residual ulcer size compared with the baseline by clinician estimate (slit-lamp) was -0.789 mm2 for the antibiotic-only group and -4.206 mm2 for the antibiotic-steroid group (p = 0.05). Among the other secondary outcomes there were no significant differences between the 2 groups.
CONCLUSIONS: No benefit was demonstrated in our primary outcome for using steroids in combination with antibiotic therapy in treatment of corneal ulcers. This study suggests that the early addition of steroids to the antibiotic treatment of corneal ulcers does not seem to be harmful when employed in a closely monitored clinical setting.
Jason Blair; William Hodge; Saeed Al-Ghamdi; Rita Balabanian; Beth Lowcock; Yi Irene Pan; Hesham Sherif; Tahra AlMahmoud; Dean Fergusson; Allan Slomovic
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Canadian journal of ophthalmology. Journal canadien d'ophtalmologie     Volume:  46     ISSN:  0008-4182     ISO Abbreviation:  Can. J. Ophthalmol.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-01     Completed Date:  2011-03-23     Revised Date:  2013-04-24    
Medline Journal Info:
Nlm Unique ID:  0045312     Medline TA:  Can J Ophthalmol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  40-5     Citation Subset:  IM    
Department of Ophthalmology, University of Ottawa, Ottawa, Ont.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use*
Bacteria / isolation & purification
Corneal Ulcer / drug therapy*,  microbiology
Dexamethasone / therapeutic use
Double-Blind Method
Drug Therapy, Combination
Eye Infections, Bacterial / drug therapy*,  microbiology
Fluoroquinolones / therapeutic use
Glucocorticoids / therapeutic use*
Middle Aged
Quality of Life
Visual Acuity / physiology
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Fluoroquinolones; 0/Glucocorticoids; 50-02-2/Dexamethasone; L4618BD7KJ/gatifloxacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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