BACTERIAL CORNEAL ULCERS - INITIAL ANTIBI OTIC-THERAPY BASED ON THE RESULTS OF GRAM STAIN

Purpose Bacterial corneal ulcers can affect the integrity of the eye a nd need therefore to be treated following strict rules. The authors pr esent a prospective study on 15 bacterial corneal ulcers for which the initial treatment with topical fortified antibiotics was guided accor ding to the results of Gram stain. Material and methods Gram positive cocci ulcers were treated with vancomycine (5 cases), Gram negative ro d ulcers with gentamycine and ticarcilline (2 cases), and the associat ion of these 3 antibiotics was used when no bacteria was found (8 case s). Results The results of the Gram stain and the culture were consist ent in all the cases. Mean healing time was statistically significantl y shorter when an infectious agent was found on Gram stain (13 days) t han when not (23 days). Conclusion These results suggest that the prog nosis of bacterial corneal ulcers is enhanced when infectious agents a re recovered and that the strategy of initiating an antibiotic therapy adapted to the gram stain results appears reliable and efficient. The successful outcome of this approach needs a perfect collaboration wit h the microbiologist.