Document Detail

Randomized clinical study for comparative evaluation of fourth-generation fluoroquinolones with the combination of fortified antibiotics in the treatment of bacterial corneal ulcers.
MedLine Citation:
PMID:  20489580     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Comparative evaluation of efficacy of monotherapy with moxifloxacin (0.5%) or gatifloxacin (0.3%) with combination therapy of cefazolin (5%) and tobramycin (1.3%) in treatment of bacterial corneal ulcers.
METHODS: Patients diagnosed with bacterial keratitis (ulcer diameter 2-8 mm) were randomized to 1 of the 3 treatment groups (tobramycin 1.3% and cefazolin 5%, gatifloxacin 0.3%, or moxifloxacin 0.5%). After obtaining corneal scrapings, assigned study medication was instilled hourly for 48 hours and tapered as per clinical response. Healing of ulcer, duration to cure, adverse reactions, antibiogram profile, treatment failures, final visual acuity, and corneal opacity size were evaluated.
RESULTS: A total of 61 patients were enrolled [cefazolin and tobramycin (n = 20), gatifloxacin (n = 21), and moxifloxacin (n = 20)]. Overall, 57 patients (93%) healed on treatment. On comparison of the mean time taken to heal, no statistically significant difference was found among all the 3 treatment groups (P = 0.98). Positive bacterial culture was obtained in only 38 patients (62%). There was no significant difference in the bacterial isolates in each treatment group. There were 4 (7%) treatment failures (perforation or nonhealing ulcer): 1 (5%) each in moxifloxacin and gatifloxacin group and 2 (10%) in fortified antibiotics group. All regimens were well tolerated.
CONCLUSION: The study failed to find a difference in the efficacy of monotherapy with fourth-generation fluoroquinolones in the treatment of bacterial corneal ulcers of 2-8 mm size when compared with combination therapy of fortified antibiotics.
Vinit Mahendra Shah; Radhika Tandon; Gita Satpathy; Niranjan Nayak; Bhavna Chawla; Tushar Agarwal; Namrata Sharma; Jeewan S Titiyal; Rasik B Vajpayee
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Cornea     Volume:  29     ISSN:  1536-4798     ISO Abbreviation:  Cornea     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-28     Completed Date:  2010-09-29     Revised Date:  2013-04-24    
Medline Journal Info:
Nlm Unique ID:  8216186     Medline TA:  Cornea     Country:  United States    
Other Details:
Languages:  eng     Pagination:  751-7     Citation Subset:  IM    
Cornea and Refractive Surgery Services and daggerDepartment of Ocular Microbiology, Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
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MeSH Terms
Anti-Bacterial Agents / adverse effects,  therapeutic use*
Aza Compounds / adverse effects,  therapeutic use*
Bacteria / drug effects,  isolation & purification
Cefazolin / adverse effects,  therapeutic use*
Corneal Ulcer / drug therapy*,  microbiology
Drug Therapy, Combination
Eye Infections, Bacterial / drug therapy*,  microbiology
Fluoroquinolones / adverse effects,  therapeutic use*
Microbial Sensitivity Tests
Middle Aged
Prospective Studies
Quinolines / adverse effects,  therapeutic use*
Tobramycin / adverse effects,  therapeutic use*
Treatment Outcome
Visual Acuity
Young Adult
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Aza Compounds; 0/Fluoroquinolones; 0/Quinolines; 25953-19-9/Cefazolin; 32986-56-4/Tobramycin; L4618BD7KJ/gatifloxacin; U188XYD42P/moxifloxacin
Comment In:
Cornea. 2011 Sep;30(9):1066; author reply 1066-7   [PMID:  21775886 ]

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

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