From the Research
Antibiotic Treatment for Corneal Ulcers
- The most commonly used antibiotics for treating corneal ulcers include fluoroquinolones, such as moxifloxacin, and fortified broad-spectrum antibiotics 1, 2, 3.
- Fluoroquinolones may be used as monotherapy for small, peripheral bacterial ulcers, while fortified broad-spectrum antibiotics are often used for more severe ulcers 1, 3.
- Cornea specialists are more likely to prescribe fortified antibiotics for severe corneal ulcers, while non-cornea specialists may prefer fluoroquinolones 3.
- The choice of antibiotic depends on the severity of the ulcer, the suspected causative organism, and the patient's overall health 2, 4.
Specific Antibiotics Used
- Moxifloxacin is a popular choice for treating less severe corneal ulcers, with 55.4% of respondents in one study preferring this antibiotic 3.
- Fortified broad-spectrum antibiotics, such as tobramycin and cefazolin, are often used for more severe ulcers, with 62.7% of respondents in one study preferring this treatment 3.
- Fluoroquinolones, such as ciprofloxacin and ofloxacin, have also been used to treat bacterial corneal ulcers, with some studies showing similar efficacy to fortified antibiotics 4.
Considerations for Antibiotic Use
- Antibiotic resistance is a persistent problem in the treatment of corneal ulcers, and the choice of antibiotic should be guided by susceptibility testing whenever possible 1, 2.
- The use of fluoroquinolones has been associated with a higher risk of serious complications, such as corneal perforation, in some studies 4.
- The duration of intensive therapy and hospital stay may be shorter with fluoroquinolone therapy compared to fortified antibiotics, but caution should be exercised in using fluoroquinolones in large, deep ulcers in the elderly 4.