CLINICAL-EVALUATION OF CIPROFLOXACIN OPHTHALMIC SOLUTION IN THE TREATMENT OF REFRACTORY BACTERIAL KERATITIS

Ciprofloxacin is a fluoroquinolone antimicrobial agent inhibiting bact erial DNA gyrase, with good In vitro and in vivo activity against many Gram-positive and Gram-negative ocular pathogens. It has low toxicity , low resistance rate and low minimum inhibitory concentration. The pu rpose of this study was to evaluate the efficacy of ciprofloxacin in t reating bacterial keratitis refractory to conventional therapy. Thirty patients with smear-proven bacterial ulcers were treated by conventio nal therapy. Of these, cultures were positive in 28 (93.3%) patients. Pseudomonas aeruginosa was isolated in 13 (46.4%) patients, nontubercu lous mycobacteria in nine (32.1%) and other bacteria in six (21.4%). F ifteen patients (50%) were cured with conventional therapy. Four patie nts (13.3%) underwent surgery due to impending corneal perforation. El even patients were shifted to ciprofloxacin therapy because of poor re sults with conventional treatment. Of these, eight (72.7%) patients we re treated successfully. No adverse events were encountered except a w hite crystalline precipitate in two cases which resolved spontaneously after discontinuation of therapy. In view of its effectiveness and lo w toxicity, ciprofloxacin should be considered in treating bacterial k eratitis which is refractory to conventional therapy.