Titre du document / Document title

The role of smears, cultures, and antibiotic sensitivity testing in the management of suspected infectious keratitis

Auteur(s) / Author(s)

MCLEOD S. D. ; KOLAHDOUZ-ISFAHANI A. ; ROSTAMIAN K. ; FLOWERS C. W. ; LEE P. P. ; MCDONNELL P. J. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

Univ. Southern California school medicine, dep. ophthalmology, Los Angeles CA, ETATS-UNIS

Résumé / Abstract

Purpose : To examine the role of routine smears, cultures, and antibiotic sensitivity testing in the treatment of suspected infectious keratitis. Methods : A retrospective chart and laboratory data review was performed for 81 consecutive patients seen in the Los Angeles County/University of Southern California Department of Ophthalmology between June 1991 and December 1993 with a primary diagnosis of community-acquired infectious keratitis. No patients were treated with antibiotics before evaluation in the authors' department, and all underwent corneal scrapings for gram-stain and bacterial, fungal, and mycobacterium cultures. Ulcers were classified as moderate or severe. All initially were treated as inpatients with a regimen including fortified cefazolin and a fortified aminoglycoside. Results : Of 81 patients, 74 ulcers were either culture- negative (n = 18) or grew bacteria (n = 56). Fungal infection was suggested in seven patients. Of the nonfungal ulcers, 33 were classified as moderate, and 41 as severe ; all moderate ulcers improved without requiring a modification in antibiotic treatment, whereas 3 severe ulcers required a change in treatment. Conclusion : Most community-acquired bacterial ulcers resolve with broad spectrum empiric therapy. Alternatives to universal culture and sensitivity testing that might be considered include selectively performing cultures for more severe or suspected non-bacterial ulcers or routinely obtaining cultures in all cases, but pursuing identification and sensitivity studies only when those data are required for therapy modification.

Revue / Journal Title

Ophthalmology   ISSN 0161-6420   CODEN OPHTDG 

Source / Source

1996, vol. 103, n^o1, pp. 23-28 (24 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1976) (Revue)

Mots-clés anglais / English Keywords

Keratitis ; Infection ; Smear ; Microorganism culture ; Sensitivity resistance ; Antibiotic ; Diagnosis ; Human ; Eye disease ; Keratopathy ;

Mots-clés français / French Keywords

Kératite ; Infection ; Frottis ; Culture microorganisme ; Sensibilité résistance ; Antibiotique ; Diagnostic ; Homme ; Oeil pathologie ; Kératopathie ;

Mots-clés espagnols / Spanish Keywords

Queratitis ; Infección ; Frotis ; Cultivo microorganismo ; Sensibilidad resistencia ; Antibiótico ; Diagnóstico ; Hombre ; Ojo patología ; Queratopatía ;

Localisation / Location

INIST-CNRS, Cote INIST : 18914, 35400005279535.0030