Abstract
Purpose Ofloxacin is a broad spectrum fluoroquinolone antibiotic with good ocular penetration. We compared ofloxacin 3% solution with a combination of fortified tobramycin sulphate and cefazolin sodium solutions in the treatment of culture-proven bacterial keratitis.
Methods Thirty eyes with culture-proven bacterial corneal ulcers were enrolled in a prospective randomised, controlled, double-masked study for comparison. The ofloxacin drop and saline were decanted into two identical-looking bottles to the tobramycin and cefazolin. The cases were randomly allocated into treatment with 0.3% ofloxacin solution or a combination of fortified antibiotics (1.5% tobramycin and 10% cefazolin solutions; control group) along with supportive cycloplegic, vitamins and anti-glaucoma therapy. Student's t-test was used to compare the results.
Results Staphylococcus aureus and coagulase-negative staphylococci were the two most common organisms isolated. Resolution of the ulcer was achieved in 93% and 87% of cases in the ofloxacin and control groups respectively. The mean time required for symptomatic relief was 7.8 ± 1.54 days and for epithelial healing 15.0 ± 3.86 days in ofloxacin group, compared with 8.33 ± 1.54 days for symptomatic relief and 15.46 ± 3.86 days for epithelial healing in the control group. Post-resolution best corrected visual acuity of 20/200 or better was achieved in all but one eye in both groups.
Conclusions Ofloxacin and combined fortified tobramycin and cefazolin topical drops were comparable for treating cases of bacterial corneal ulcer. However, considering its easy availability and cost-effectiveness, monotherapy with ofloxacin is preferred over the combined fortified tobramycin and cefazolin therapy.
Similar content being viewed by others
Article PDF
References
Hyndiuk RA, Eiferman RA, Caldwell DR, et al. Comparison of ciprofloxacin to tobramycin and cefazolin in bacterial keratitis. Ophthalmology 1986;103:1854–63.
Barrman LR, Leopold IH . The potential use of quinolones in future ocular antimicrobial therapy. Am J Ophthalmol 1988;106:227–9.
Mohan M, Sangawe JLF, Mahajan VM . Pathogenesis of experimentally produced ulcer in rabbits. Ann Ophthalmol 1984;16:246–51.
Jones DB, Liesegang TJ, Robinson NM . In: Washington JA II, coordinating editor. Laboratory diagnosis of ocular infections. Washington DC: American Society for Microbiology, 1981.
Drew Richard H, Pharm BS, Gallis HA . Preview of new drugs. Pharmacol Ther 1988;8:35–45.
Gwon A . Ofloxacin vs tobramycin for external ocular infection. Arch Ophthalmol 1992;110:1234–7.
O'Brien TP, Maureen GM, Fink NE, Sarfara FA, Alfonso E, et al. Efficacy of ofloxacin vs cefazolin and tobramycin for bacterial keratitis. Arch Ophthalmol 1995;113:1257–63.
The Ofloxacin Study Group. Ofloxacin monotherapy for the primary treatment of microbial keratitis. Ophthalmology 1997;104:1902–9.
Liesegang TJ, Foster RK . Spectrum of microbial keratitis in South Florida. Am J Ophthalmol 1980;90:38–47.
Panda A, Sharma N, Satpathy G, et al. Childhood keratitis. Advances in corneal research. New York: Plenum Press, 1997:491–9.
McLeod SD, Isfahani KA, Rostamian K, et al. The role of smears, cultures and antibiotic sensitivity testing in the management of suspected infectious keratitis. Ophthalmology 1996;103:23–8.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Panda, A., Ahuja, R. & Sastry, S. Comparison of topical 0.3% ofloxacin with fortified tobramycin plus cefazolin in the treatment of bacterial keratitis. Eye 13, 744–747 (1999). https://doi.org/10.1038/eye.1999.220
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1038/eye.1999.220