Document Detail


Corneal ulceration in south-east Asia III: prevention of fungal keratitis at the village level in south India using topical antibiotics.
MedLine Citation:
PMID:  16916874     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To determine whether topical antifungal prophylaxis distributed by paid village health workers (VHWs) in south India is necessary after corneal abrasion to prevent fungal keratitis in a population where half of the ulcers are fungal.
METHODS: Two panchayaths (village administrative units in Madurai district with a combined population of 48 039 were followed prospectively for 18 months by 15 VHWs who were trained to identify post-traumatic corneal abrasions. Patients fulfilling the eligibility criteria were randomised into two groups and treated with either 1% chloramphenicol and 1% clotrimazole ointment or 1% chloramphenicol and a placebo ointment three times a day for 3 days. Patients, doctors and VHWs were blinded to treatment.
RESULTS: During the 18-month period, 1365 people reported to VHWs with ocular injuries, of whom 374 with corneal abrasions were eligible for treatment. Of these, 368 (98.5%) abrasions healed without complications. Two patients had mild localised allergic reactions to the ointment, two dropped out and two patients in the placebo group developed microscopic culture-negative corneal stromal infiltrates that healed in 1 week with natamycin drops.
CONCLUSIONS: Both fungal and bacterial ulcers that occur after traumatic corneal abrasions seem to be effectively prevented in a village setting using only antibiotic prophylaxis.
Authors:
M Srinivasan; M P Upadhyay; B Priyadarsini; R Mahalakshmi; J P Whitcher
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2006-08-17
Journal Detail:
Title:  The British journal of ophthalmology     Volume:  90     ISSN:  0007-1161     ISO Abbreviation:  Br J Ophthalmol     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-20     Completed Date:  2006-12-11     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  0421041     Medline TA:  Br J Ophthalmol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1472-5     Citation Subset:  IM    
Affiliation:
Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Distribution
Aged
Antifungal Agents / therapeutic use*
Child
Chloramphenicol / therapeutic use
Clotrimazole / therapeutic use
Community Health Workers
Cornea / injuries
Corneal Ulcer / etiology,  prevention & control*
Double-Blind Method
Drug Combinations
Eye Infections, Fungal / etiology,  prevention & control*
Female
Follow-Up Studies
Humans
India
Male
Middle Aged
Ointments
Prospective Studies
Sex Distribution
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Drug Combinations; 0/Ointments; 23593-75-1/Clotrimazole; 56-75-7/Chloramphenicol
Comments/Corrections

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