Pinar-Sueiro Sergio, Sota Mercedes, Lerchundi Telmo-Xabier, Gibelalde Ane, Berasategui Bárbara, Vilar Begoña, Hernandez Jose Luis
Department of Ophthalmology, Cruces Hospital, Plaza Cruces s/n, E-48903, Barakaldo, Bizkaia, Spain,
Curr Infect Dis Rep. 2012 Jan 29. doi: 10.1007/s11908-012-0238-8.
The objective of this paper is to review the main findings of the largest studies on the etiopathogenesis and microbiology of the development of dacryocystitis and to formulate clinical and surgical guidelines based on said studies and on our experience at Cruces Hospital, the Basque Country, Spain. The most common sign of this entity is the distal nasolacrimal duct obstruction, and this should be treated to prevent clinical relapse. The time when surgery should be indicated mainly depends on the clinical signs and symptoms, age and general status of a patient. Given the germs isolated in cases of dacryocystitis, antibiotic therapy against Gram positive (S. aureus, S. pneumoniae, S. epidermidis) and Gram negative bacteria (H. influenzae, P. aeruginosa) should be administered, orally in adults and intravenously in pediatric patients, prior to surgery. Gentamicin and amoxicillin-clavulanic acid have been found to be effective against the bacteria commonly implicated in the etiopathogenesis of this entity.
本文的目的是回顾关于泪囊炎发病机制和微生物学的最大规模研究的主要发现，并根据上述研究以及我们在西班牙巴斯克地区克鲁塞斯医院的经验制定临床和手术指南。该疾病最常见的体征是鼻泪管远端阻塞，对此应进行治疗以防止临床复发。手术时机的选择主要取决于患者的临床体征和症状、年龄及一般状况。鉴于在泪囊炎病例中分离出的病菌，手术前应针对革兰氏阳性菌（金黄色葡萄球菌、肺炎链球菌、表皮葡萄球菌）和革兰氏阴性菌（流感嗜血杆菌、铜绿假单胞菌）进行抗生素治疗，成人采用口服给药，儿童患者采用静脉给药。已发现庆大霉素和阿莫西林 - 克拉维酸对该疾病发病机制中常见的细菌有效。
