Abstract
· Background: Pseudomonal keratitis is a serious and potentially blinding infection. · Methods: We treated 12 patients with culture-positive fulminant pseudomonal keratitis with a topical combination of ceftazidime ophthalmic solution (50 mg/ml) and aminoglycosides (14 mg/ml). None of these patients had responded to the standard initial therapy with topical fortified gentamicin or tobramycin (14 mg/ml) combined with cefazolin (50 mg/ml). · Results: Substitution of cefazolin by ceftazidime achieved a remarkable clinical improvement during the first 24–48 h of administration in all cases. The average time of healing after initiation of the combination of ceftazidime and fortified aminoglycosides was 21±15 days. No serious side effects accompanied ceftazidime administration. In vitro susceptibility testing showed resistance to gentamicin or tobramycin in 33% of cases (4/12) and sensitivity to ceftazidime in all cases. · Conclusions: The combination of ceftazidime, in a 5% solution, and fortified aminoglycosides (1.4%) may be a useful, safe and effective topical therapy for the treatment of pseudomonal keratitis resistant to aminoglycosides.
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Received: 26 February 1998 Revised version received: 29 April 1998 Accepted: 28 May 1998
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Robinson, A., Kremer, I., Avisar, R. et al. The combination of topical ceftazidime and aminoglycosides in the treatment of refractory pseudomonal keratitis. Graefe's Arch Clin Exp Ophthalmol 237, 177–180 (1999). https://doi.org/10.1007/s004170050215
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DOI: https://doi.org/10.1007/s004170050215