Community Opinions in the Management of Corneal Ulcers and Ophthalmic Antibiotics: A Survey of 4 States
Community Opinions in the Management of Corneal Ulcers and Ophthalmic Antibiotics: A Survey of 4 States
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DOI：
10.1097/icl.0b013e3181e3ef45
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发表时间：
2010-07-01
影响因子：
2.3
通讯作者：
Israel, Heidi A.
中科院分区：
文献类型：
--
作者：
Hsu, Hugo Y.;Nacke, Randall;Israel, Heidi A.
目的：评估眼科社区目前的意见，管理细菌性角膜炎和使用目前可用的眼科抗生素。方法：一个匿名问卷邮寄给眼科医生在加州，佛罗里达，伊利诺伊州和密苏里州。结果：回收有效问卷629份（10.3%）。在角膜溃疡的管理中，42.2%的综合眼科医生和75.3%的角膜专家有时会进行革兰氏染色。共有73.3%的综合眼科医生和93.7%的角膜专家有时进行角膜培养。共有88.8%的综合眼科医生和76%的角膜专家开始使用较新的氟喹诺酮类抗生素治疗。共有12.1%的综合眼科医生和41%的角膜专家会选择强化抗生素治疗角膜溃疡。认为强化抗生素具有上级优势的患者比例从综合眼科医生的17.7%到角膜专家的33.3%不等。共有65.7%的综合眼科医生表示，较新的氟喹诺酮类药物已经影响了他们的做法，58.3%表示，他们代表了一个改进，在旧的fluoroquinolones.Conclusions：大多数响应眼科医生开始经验性治疗与较新的氟喹诺酮类抗生素角膜溃疡，放弃革兰氏染色和培养。然而，受访者对新型氟喹诺酮类药物并不普遍乐观。综合眼科医生和角膜专家对抗生素的实践模式和观点几乎普遍不同。更大规模、更详细的调查和更具体的分析将有助于进一步确定导致不同管理选择和意见的因素。
Objective: To evaluate the ophthalmic community's current opinions of the management of bacterial keratitis and usage of the currently available ophthalmic antibiotics.Methods: An anonymous questionnaire was mailed to ophthalmologists in California, Florida, Illinois, and Missouri. The results were tabulated and analyzed statistically.Results: Six hundred twenty-nine usable questionnaires (10.3%) were returned. In the management of corneal ulcers, 42.2% of comprehensive ophthalmologists and 75.3% of cornea specialists perform Gram stains some of the time. A total of 73.3% of comprehensive ophthalmologists and 93.7% of cornea specialists perform corneal cultures some of the time. A total of 88.8% of comprehensive ophthalmologists and 76% of cornea specialists initiate treatment with the newer fluoroquinolone antibiotics. A total of 12.1% of comprehensive ophthalmologists and 41% of cornea specialists would select fortified antibiotics for the treatment of corneal ulcers. The percentage of those who feel that fortified antibiotics are superior ranges from 17.7% for comprehensive ophthalmologists to 33.3% for cornea specialists. A total of 65.7% of comprehensive ophthalmologists indicate that the newer fluoroquinolones have impacted their practices, and 58.3% indicate that they represent an improvement over older fluoroquinolones.Conclusions: Most responding ophthalmologists initiate empiric therapy with the newer fluoroquinolone antibiotics for corneal ulcers, forgoing Gram staining and culturing. However, respondents are not universally sanguine about the newer fluoroquinolones. The practice patterns and opinions on antibiotics differ almost universally between comprehensive ophthalmologists and cornea specialists. Larger, more detailed surveys and more specific analyses would help to further establish the factors that lead to differing management choices and opinions.