Blanton C L, Rapuano C J, Cohen E J, Laibson P R
Cornea Department, Wills Eye Hospital, Philadelphia, PA, USA.
CLAO J. 1996 Apr;22(2):136-40.
The common occurrence of failed medical treatment in microbial keratitis led us to investigate this phenomenon.
We retrospectively reviewed all ulcers that presented to our department for 24 consecutive months. We classified each ulcer as either a therapeutic success or failure based on a precise definition of the response to initial antibiotic selection. We then analyzed multiple factors including: antibiotic selection, ophthalmic disease, ulcer characteristics, and management, to determine their significance in the success or failure in treating microbial keratitis. Complications were also examined.
Important factors in failure were non-fortified antibiotics (P < 0.001), ocular surface disease (P = 0.0178) and outpatient management (P < 0.001). Large ulcers (P = 0.051) were of borderline significance. Sensitivity results reflect high sensitivity among successfully treated patients when appropriate antibiotics are chosen.
This report provides insight into current practice patterns and potential means to improve success in managing microbial keratitis.
微生物性角膜炎治疗失败的情况屡见不鲜，这促使我们对该现象展开调查。
我们回顾性分析了连续24个月内在我科就诊的所有溃疡病例。根据对初始抗生素选择反应的精确定义，将每个溃疡分类为治疗成功或失败。然后我们分析了多个因素，包括：抗生素选择、眼科疾病、溃疡特征和治疗管理，以确定它们在微生物性角膜炎治疗成功或失败中的重要性。同时也对并发症进行了检查。
治疗失败的重要因素包括非强化抗生素（P < 0.001）、眼表疾病（P = 0.0178）和门诊治疗管理（P < 0.001）。大溃疡（P = 0.051）具有临界显著性。敏感性结果表明，当选择合适的抗生素时，成功治疗的患者中敏感性较高。
本报告深入探讨了当前的治疗模式以及提高微生物性角膜炎治疗成功率的潜在方法。
