The efficacy and safety of topical polymyxin B, neomycin and gramicidin for treatment of presumed bacterial corneal ulceration
The efficacy and safety of topical polymyxin B, neomycin and gramicidin for treatment of presumed bacterial corneal ulceration
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DOI：
10.1136/bjo.88.1.25
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发表时间：
2004-01-01
影响因子：
4.1
通讯作者：
Jager, MJ
中科院分区：
文献类型：
--
作者：
Bosscha, MI;van Dissel, JT;Jager, MJ
目的：评估莱顿大学医学中心局部使用多粘菌素 B、新霉素和短杆菌肽治疗疑似细菌性角膜溃疡的临床疗效和安全性。方法：对 1995 年 4 月至 2002 年 2 月期间诊断为疑似细菌性角膜溃疡的患者进行回顾性鉴定和评估；分析了临床和微生物学特征以及对治疗的反应。所有患者均接受 Polyspectran 滴眼液治疗。结果：本次分析总共纳入 91 名患者。 46 名患者 (51%) 的细菌学培养结果呈阳性，显示出 51 种微生物。金黄色葡萄球菌（29.4%）和铜绿假单胞菌（23.5%）是最常见的细菌。 18 名患者在角膜溃疡完全愈合之前更换了治疗，4 名患者失访。在完成 Polyspectran 治疗的 69 名患者中，68 名患者 (99%) 发生了上皮再形成，平均需要 12.6 天（中位数 8）天。 91 名患者中，有 4 例穿孔，1 例内脏掏空。报告了 7 例毒性或过敏反应。结论：本研究表明，多粘菌素 B、新霉素和短杆菌肽联合使用是治疗疑似角膜溃疡的有效且安全的方法。
Aim: To evaluate the clinical efficacy and safety of topical polymyxin B, neomycin, and gramicidin for the treatment of suspected bacterial corneal ulceration at the Leiden University Medical Center.Methods: Patients with a diagnosis of a suspected bacterial corneal ulcer between April 1995 and February 2002 were retrospectively identified and reviewed; clinical and microbiological features and response to therapy were analysed. All patients were treated with Polyspectran eye drops.Results: In total, 91 patients were included in this analysis. Bacteriological cultures of 46 patients (51%) were positive and revealed 51 microorganisms. Staphylococcus aureus (29.4%) and Pseudomonas aeruginosa (23.5%) were the most frequently encountered bacteria. Eighteen patients switched therapy before complete healing of the corneal ulceration, four patients were lost to follow up. Of the 69 patients who completed Polyspectran treatment, re-epithelialisation occurred in 68 patients (99%) and on average took 12.6 ( median 8) days. Among 91 patients, there were four perforations and one evisceration. Seven toxic or allergic reactions were reported.Conclusion: This study shows that the combination of polymyxin B, neomycin, and gramicidin is an effective and safe treatment of suspected corneal ulceration.