TY - CHAP M1 - Book, Section TI - Infectious Keratitis A1 - Duncan, Jacque L. A1 - Parikh, Neeti B. A1 - Seitzman, Gerami D. A2 - Papadakis, Maxine A. A2 - McPhee, Stephen J. A2 - Rabow, Michael W. A2 - McQuaid, Kenneth R. PY - 2022 T2 - Current Medical Diagnosis & Treatment 2022 AB - Risk factors for bacterial keratitis include contact lens wear—especially overnight wear—and corneal trauma, including refractive surgery. The pathogens most commonly isolated are staphylococci, including MRSA; streptococci; and Pseudomonas aeruginosa, Moraxella species, and other gram-negative bacilli. The cornea has an epithelial defect and an underlying opacity. Hypopyon may be present (eFigure 7–23). Topical fluoroquinolones, such as levofloxacin 0.5%, ofloxacin 0.3%, norfloxacin 0.3%, or ciprofloxacin 0.3%, are commonly used as first-line agents as long as local prevalence of resistant organisms is low (Table 7–2). For severe central ulcers, diagnostic scrapings can be sent for Gram stain and culture. Treatment may include compounded high-concentration topical antibiotic drops applied hourly day and night for at least the first 48 hours. Fourth-generation fluoroquinolones (moxifloxacin 0.5% and gatifloxacin 0.3%) are also frequently used in this setting. Although early adjunctive topical corticosteroid therapy may improve visual outcome, it should be prescribed only by an ophthalmologist. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1184192124 ER -