Comparison of topical 0.3% ofloxacin with fortified tobramycin plus cefazolin in the treatment of bacterial keratitis

Purpose Ofloxacin is a broad spectrum fluoroquinolone antibiotic with good ocular penetration. We compared ofloxacin 3% solution with a combination of fortified tobramycin sulphate and cefazolin sodium solutions in the treatm ent of culture-proven bacterial keratitis. Methods Thirty eyes with culture-proven bacterial corneal ulcers were enrol led in a prospective randomised, controlled, double-masked study for compar ison. The ofloxacin drop and saline were decanted into two identical-lookin g bottles to the tobramycin and cefazolin. The cases were randomly allocate d into treatment with 0.3% ofloxacin solution or a combination of fortified antibiotics (1.5% tobramycin and 10% cefazolin solutions; control group) a long with supportive cycloplegic, vitamins and antiglaucoma therapy. Studen t's t-test was used to compare the results. Results Staphylococcus aureus and coagulase-negative staphylococci were the two most common organisms isolated. Resolution of the ulcer was achieved i n 93% and 87% of cases in the ofloxacin and control groups respectively. Th e mean time required for symptomatic relief was 7.8 +/- 1.54 days and for e pithelial healing 15.0 +/- 3.86 days in ofloxacin group, compared with 8.33 +/- 1.54 days for symptomatic relief and 15.46 +/- 3.86 days for epithelia l healing in the control group. Post-resolution best corrected visual acuit y of 20/200 or better was achieved in all but one eye in both groups. Conclusions Ofloxacin and combined fortified tobramycin and cefazolin topic al drops were comparable for treating cases of bacterial conceal ulcer. How ever, considering its easy availability and cost-effectiveness, monotherapy with ofloxacin is preferred over the combined fortified tobramycin and cef azolin therapy.