Cornea

Skip Navigation LinksHome > September 2014 - Volume 33 - Issue 9 > Use of Topical Colistin in Multiple Drug-Resistant Pseudomon...
Cornea:
doi: 10.1097/ICO.0000000000000184
Clinical Science

Use of Topical Colistin in Multiple Drug-Resistant Pseudomonas aeruginosa Bacterial Keratitis

Jain, Rajat MS*; Murthy, Somasheila I. MS; Motukupally, Swapna R. MD; Jain, Mitesh MS

Collapse Box

Abstract

Purpose: The aim of this study was to report the utility of topical colistin in multi–drug resistant Pseudomonas aeruginosa bacterial keratitis.

Methods: Retrospective interventional case series included 8 patients with culture-proven multi–drug resistant P. aeruginosa (MDR-PA) bacterial keratitis who presented from June 2011 to January 2012 and were treated with colistin 0.19% as monodrug therapy. Clinical/microbiological data were collected from medical records. All patients underwent microbiological corneal scraping. Intensive half-hourly therapy with broad-spectrum antibiotics was changed to colistin 0.19% when antibiotic sensitivity reports were available. The outcome was a “complete success” if resolution of infection occurred with scar formation without any subsequent recurrence up to 2 weeks and “partial success” if it also required a cyanacrylate glue application. The outcome was a “failure” if the patient required a therapeutic graft or if the infection could not be controlled and the eye needed evisceration.

Results: The mean age was 45 ± 16 years; the M:F ratio was 1:1. Seven patients had a history of ocular surgery. The mean size of the infiltrate was 15.41 ± 22.2 mm2 and was full thickness in 5 patients. Success was achieved in 7 out of 8 patients, and the infiltrate gradually decreased with resolution of infection in a mean duration of 30.5 ± 16 days. Complete and partial success were noted in 4 and 3 patients, respectively. The final visual acuity was 20/60 or better in 4 patients. One patient required a sclerocorneal patch graft. No complications of topical colistin were noticed.

Conclusions: The early use of topical colistin 0.19% was found to be a safe and effective alternative in the management of multi–drug resistant P. aeruginosa bacterial keratitis.

© 2014 by Lippincott Williams & Wilkins.

Login

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.