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

doi:10.1016/S0161-6420(95)30771-3

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 journal › Article › peer-review

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 language	English (US)
Pages (from-to)	1943-1948
Number of pages	6
Journal	Ophthalmology
Volume	102
Issue number	12
DOIs	https://doi.org/10.1016/S0161-6420(95)30771-3
State	Published - 1995
Externally published	Yes

ASJC Scopus subject areas

Ophthalmology

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title = "The Importance of Initial Management in the Treatment of Severe Infectious Corneal Ulcers",

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.",

author = "McLeod, {Stephen D.} and LaBree, {Laurie D.} and Ramin Tayyanipour and Flowers, {Charles W.} and Lee, {Paul P.} and McDonnell, {Peter J.}",

note = "Funding Information: Originally received: May 3, 1995. Revision accepted: July 17, 1995. I Doheny Eye Institute, Los Angeles. 2Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles. 3 Departm ent of Preventive Medicine, University of Southern California School of Medicine, Los Angeles. Dr. McLeod currently is affiliated with the University of Illinois at Chicago. Department of Ophthalmology, Chicago. Presented in part at the Association for Research in Vision and Ophthalmology Meeting. Sarasota. May 1994. Supported in part by an unrestricted grant from Research to Prevent Blindness, New York, New York. Dr. McDonn ell isa Research to Prevent Blindness William and Mary Greve Intern ational Research Scholar. Copyright: Copyright 2017 Elsevier B.V., All rights reserved.",

year = "1995",

doi = "10.1016/S0161-6420(95)30771-3",

language = "English (US)",

volume = "102",

pages = "1943--1948",

journal = "Ophthalmology",

issn = "0161-6420",

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T1 - The Importance of Initial Management in the Treatment of Severe Infectious Corneal Ulcers

AU - McLeod, Stephen D.

AU - LaBree, Laurie D.

AU - Tayyanipour, Ramin

AU - Flowers, Charles W.

AU - Lee, Paul P.

AU - McDonnell, Peter J.

N1 - Funding Information: Originally received: May 3, 1995. Revision accepted: July 17, 1995. I Doheny Eye Institute, Los Angeles. 2Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles. 3 Departm ent of Preventive Medicine, University of Southern California School of Medicine, Los Angeles. Dr. McLeod currently is affiliated with the University of Illinois at Chicago. Department of Ophthalmology, Chicago. Presented in part at the Association for Research in Vision and Ophthalmology Meeting. Sarasota. May 1994. Supported in part by an unrestricted grant from Research to Prevent Blindness, New York, New York. Dr. McDonn ell isa Research to Prevent Blindness William and Mary Greve Intern ational Research Scholar. Copyright: Copyright 2017 Elsevier B.V., All rights reserved.

PY - 1995

Y1 - 1995

N2 - 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.

AB - 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.

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

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