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Management and treatment of contact lens-related Pseudomonas keratitis

DOI: http://dx.doi.org/10.2147/OPTH.S25168

Keywords: Pseudomonas, keratitis, contact lens

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nagement and treatment of contact lens-related Pseudomonas keratitis Review (4217) Total Article Views Authors: Willcox MD Published Date June 2012 Volume 2012:6 Pages 919 - 924 DOI: http://dx.doi.org/10.2147/OPTH.S25168 Received: 28 March 2012 Accepted: 30 April 2012 Published: 18 June 2012 Mark DP Willcox School of Optometry and Vision Science, University of New South Wales, Sydney, Australia Abstract: Pubmed and Medline were searched for articles referring to Pseudomonas keratitis between the years 2007 and 2012 to obtain an overview of the current state of this disease. Keyword searches used the terms "Pseudomonas" + "Keratitis" limit to "2007–2012", and ["Ulcerative" or "Microbial"] + "Keratitis" + "Contact lenses" limit to "2007–2012". These articles were then reviewed for information on the percentage of microbial keratitis cases associated with contact lens wear, the frequency of Pseudomonas sp. as a causative agent of microbial keratitis around the world, the most common therapies to treat Pseudomonas keratitis, and the sensitivity of isolates of Pseudomonas to commonly prescribed antibiotics. The percentage of microbial keratitis associated with contact lens wear ranged from 0% in a study from Nepal to 54.5% from Japan. These differences may be due in part to different frequencies of contact lens wear. The frequency of Pseudomonas sp. as a causative agent of keratitis ranged from 1% in Japan to over 50% in studies from India, Malaysia, and Thailand. The most commonly reported agents used to treat Pseudomonas keratitis were either aminoglycoside (usually gentamicin) fortified with a cephalosporin, or monotherapy with a fluoroquinolone (usually ciprofloxacin). In most geographical areas, most strains of Pseudomonas sp. (≥95%) were sensitive to ciprofloxacin, but reports from India, Nigeria, and Thailand reported sensitivity to this antibiotic and similar fluoroquinolones of between 76% and 90%.

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