Ophthalmic Antibiotic Resistance Study

描述：（申请人的摘要）微生物性角膜炎是一种常见的， 经济上重要的眼病，尽管可用 抗生素治疗，可以降低视力和生活质量。一个主要 未解决的问题是微生物实验室在指导 决策的这项试点研究的目标是利用临床和 来自患有微生物角膜感染的患者的微生物学数据， 确定抗菌素耐药性如何影响结果。采用回顾性 队列研究设计，这项流行病学调查将检查 初始抗生素治疗的适当性和体外 角膜分离株对视力、抗生素使用时间的敏感性 治疗和需要手术的眼部并发症。多变量 逻辑回归和比例风险分析将控制 潜在的混杂因素（包括人口统计学变量，疾病持续时间， 严重程度参数和连续治疗），并将考虑可能的影响 修饰符（如微生物分类和最小抑菌浓度）， 确定调整后的相对效应措施。从这方面获得的知识 研究对视觉研究和临床具有潜在的高度影响。 实践，并有可能指导更广泛的调查， 抗生素耐药性问题和抗生素的最佳使用， 眼科

DESCRIPTION: (Applicant's Abstract) Microbial keratitis is a common, economically important ocular disease that, despite the availability of antimicrobial therapy, can reduce vision and the quality of life. A major unresolved issue is the role of the microbiology laboratory in guiding decision-making. The goal of this pilot research is to use clinical and microbiologic data from patients who have had microbial corneal infection to determine how antimicrobial resistance affects outcome. Using a retrospective cohort study design, this epidemiological investigation will examine the effect of the appropriateness of initial antibiotic therapy and the in vitro susceptibility profile of corneal isolates on vision, length of antibiotic treatment, and ocular complications requiring surgery. Multivariable logistic-regression and proportional-hazards analyses will control for potential confounders (including demographic variables, disease duration, severity parameters, and adjunctive therapy) and will consider possible effect modifiers (such as microbial taxonomy and minimal inhibitory concentration) to determine adjusted relative effect measures. The knowledge derived from this research has a potentially high impact on vision research and on clinical practice and has the potential to direct broader investigations into the problem of antimicrobial resistance and the optimal use of antibiotics in ophthalmology.