Current therapy for bacterial keratitis and bacterial conjunctivitis.

Therapy of bacterial keratitis and conjunctivitis requires that antibiotics be administered to eliminate viable bacteria. Only a limited number of ophthalmic antibiotics are commercially available. Although generally adequate for the treatment of bacterial conjunctivitis, the commercial preparations are believed to contain too low a concentration of antibiotic for the treatment of bacterial keratitis. Using products designed for parenteral administration, the ophthalmologist or the pharmacist formulates so-called fortified preparations containing much higher antibiotic concentrations. Because of their limited spectrum of action, two fortified preparations generally are administered concurrently. Topical application is the most effective route of antibiotic administration for treatment of bacterial keratitis. Antibiotics may also be injected periocularly, a method with risk, or intravenously, a method of uncertain efficacy.