Risk factors for treatment outcome of suspected microbial keratitis
Risk factors for treatment outcome of suspected microbial keratitis
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DOI：
10.1136/bjo.83.9.1027
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发表时间：
1999-09-01
影响因子：
4.1
通讯作者：
Butcher, J
中科院分区：
文献类型：
--
作者：
Morlet, N;Minassian, D;Butcher, J
背景-疑似微生物性角膜炎的初步治疗通常是成功的。虽然诸如接触透镜使用等风险被公认为是微生物角膜炎的致病因素，但对影响治疗结果的风险因素知之甚少。本研究评估的风险因素，评估在诊断为预后指标的主要治疗failure. Methods，患者前瞻性地参加了氧氟沙星治疗试验和数据有关的症状，治疗，过去和并发的眼部疾病收集沿着角膜溃疡的大小在裂隙灯下的测量。所有患者均进行刮片微生物调查，并接受氧氟沙星（0.3%）或标准治疗的强化头孢呋辛和庆大霉素滴剂。治疗成功是溃疡完全愈合，在治疗开始后2周内上皮缺损尺寸为零。通过使用单变量和分层分析将治疗失败、愈合延迟或培养阳性的患者与其他患者进行比较，选择重要的预后指标。然后，这些被用于泊松模型的多元回归分析，以估计相对风险的主要预后variable.Results-Of 118例患者参加了这项研究，14被确定为主要治疗失败，17愈合缓慢，和15惰性溃疡。培养阳性49例。多变量分析表明，60岁或60岁以上的患者中，大的培养阳性溃疡有5.5倍的初次治疗失败的风险（p
Background-Primary treatment for suspected microbial keratitis is generally successful. Although risks such as contact lens use are well recognised as causative factors for microbial keratitis, little is known about the risk factors that influence treatment outcome. The present study evaluates the risk factors assessed at diagnosis as prognostic indicators of primary treatment failure.Methods-Patients were prospectively enrolled in the ofloxacin treatment trial and data concerning symptoms, treatments, past and concurrent eye disease were collected along with the measurement of corneal ulcer size at the slit lamp. All patients were scraped for microbiological investigation, and treated with either ofloxacin (0.3%) or standard therapy of fortified cefuroxime and gentamicin drops. Treatment success was complete healing of the ulcer with zero dimensions of the epithelial defect within 2 weeks of start of treatment. The important prognostic indicators were selected by comparison among those who failed treatment, had delayed healing, or were culture positive with other patients using univariate and stratified analysis. These were then used in a Poisson model for multiple regression analysis to estimate the relative risk of the main prognostic variables.Results-Of the 118 patients enrolled in the study, 14 were identified as primary treatment failures, 17 had slow healing, and 15 indolent ulcers. There were 49 culture positive patients. The multivariate analysis identified that large culture positive ulcers in patients 60 years or older had 5.5 times the risk of primary treatment failure (p