Davis S D, Sarff L D, Hyndiuk R A
Invest Ophthalmol Vis Sci. 1978 Sep;17(9):916-8.
Two long-term therapy trials with high concentrations of antibiotic were carried out to determine the duration of therapy required to achieve bacteriologic cure of experimental Pseudomonas keratitis in guinea pigs. In the first study, corneas still contained Pseudomonas after 4 days of continual topical therapy with either tobramycin 400 mg/ml, amikacin 250 mg/ml, ticarcillin 400 mg/ml, or carbenicillin 400 mg/ml. In an 11-day trial of topical therapy with tobramycin 20 mg/ml, 34 of 36 corneas grew no Pseudomonas after 6 or more days of therapy. The bacteriologic response to therapy in this model occurred in two phases. About 99.9% or more of the organisms in the cornea were killed in the first 24 hr of therapy. The numbers of bacteria remaining in the cornea declined gradually over the next several days until the corneas were sterile. Optimal antibiotic therapy may include two stages: initial intensive therapy with high concentrations of antibiotic applied frequently to achieve a large rapid decrease in numbers of organisms in the cornea, followed by prolonged, less intensive therapy to eradicate organisms and prevent relapse.
进行了两项使用高浓度抗生素的长期治疗试验，以确定实现豚鼠实验性铜绿假单胞菌角膜炎细菌学治愈所需的治疗持续时间。在第一项研究中，用400mg/ml妥布霉素、250mg/ml阿米卡星、400mg/ml替卡西林或400mg/ml羧苄西林持续局部治疗4天后，角膜仍含有铜绿假单胞菌。在一项使用20mg/ml妥布霉素进行11天局部治疗的试验中，36只角膜中有34只在治疗6天或更长时间后未培养出铜绿假单胞菌。该模型中对治疗的细菌学反应分为两个阶段。在治疗的最初24小时内，角膜中约99.9%或更多的细菌被杀死。在接下来的几天里，角膜中残留的细菌数量逐渐减少，直到角膜无菌。最佳抗生素治疗可能包括两个阶段：首先进行强化治疗，频繁应用高浓度抗生素，以使角膜中的细菌数量迅速大幅减少，然后进行长期、强度较低的治疗，以根除细菌并防止复发。
