The Importance of Initial Management in the Treatment of Severe Infectious Corneal Ulcers

Stephen D. McLeod, Laurie D. LaBree, Ramin Tayyanipour, Charles W. Flowers, Paul P. Lee, Peter J. McDonnell

Research output: Contribution to journalArticle

Abstract

Purpose: To identify factors that influence the outcome of patients with severe infectious corneal ulcers. Method: A retrospective review was performed of the hospital records of all such patients admitted to the Doheny Eye Hospital during a 30 month period. Outcome variables examined were change in visual acuity, duration of hospitalization, hospital charges, and percentage of patients who required penetrating keratoplasty. Results: Sixty-two ulcers were included. An organism was identified and antibiotic sensitivities established in 52 patients (84%). Inpatient therapy involved a combination of fortified aminoglycoside and cephalosporin antibiotics in 39 patients (63%) and was found to be appropriate on the basis of sensitivity studies in 49 (94%) of 52 patients. Inappropriate initial treatment was related to increased hospital charge (P= 0.024) as well as increased risk of penetrating keratoplasty (P= 0.001). Conclusions: Appropriate initial therapy is most critical in the course of serious corneal ulcers, and aggressive, broad-spectrum antibiotic coverage is advocated.

Original languageEnglish (US)
Pages (from-to)1943-1948
Number of pages6
JournalOphthalmology
Volume102
Issue number12
DOIs
StatePublished - Jan 1 1995

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ASJC Scopus subject areas

  • Ophthalmology

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