Outcome of management of patients with bacterial keratatis in jordan

Authors:Ahmed E. Khatatbeh, Walid N.Qubain, Rame khasawneh, Asem Al-Momani
Int J Biol Med Res. 2012; 3(2): 1602 – 1605  |  PDF File

Abstract

Abstract Aim: to evaluate the outcome of management of patients with infective keratatis and the outcome of the culture results. Method: a prospective study performed in Royal Medical Services hospitals between Jan. 2009 and Jan. 2012, all patient who were clinically diagnosed to have bacterial keratitis included in this study, patient who received any type of topical or systemic antibiotics were excluded from the study, a total of 78 patients were divided into two groups; Group A patients(54 patients) are those who have infiltrates of less than 2mm in diameter and 2mm away from visual axis and less than +2 cells reaction in anterior chamber , they received a monotherpy of hourly ofloxacin eye drop, the remaining 24 patients were included in Group B and receive a combined hourly treatment of fortified gentmycin (3 mg/ml ) and cefazolin (50 mg/ml), then Corneal scrapings were done and sent for cultue to all patients, and the patients were admitted and followed up daily for seven days. Results: the mean age for all patients was 29 years, and male to female ratio was 1:1.3, group A patients with negative culture had excellent and quick response to ofloxacin monotherapy; by the 3rd day 80% of patients improved while those positive culture had excellent but delayed response to Ofloxacin, 80% improved by the 5th day of treatment. Group B patients with negative culture had excellent and quick response to combined therapy; by the 3rd day all patients improved while in those with positive culture there was excellent but delayed response to combined therapy; by the 3rd day only 60% improved but at the 6th day 90% improved. Conclusion: Bacterial keratatis with Small peripheral infiltrates and mild anterior chamber reaction can be effectively treated by monotherpy of oflxacin without the need for culture, while fortified gentamycin/ cefazolin combination therpy was effective in most cases of severe forms of bacterial keratatis.