Overview: Initial antimicrobial therapy for microbial keratitis

Abstract

Fluoroquinolones are used as monotherapy in many centres and are highly effective (Table I). Tissue concentration can vary dramatically depending on associated conditions and so can make estimation of the true tissue concentration difficult. The determinants of corneal and aqueous antibiotic concentration are based on a standard concentration of drug and frequent intensive applications. However other factors such as the presence of epithelial defect and the formulation can markedly alter penetration of drug into the cornea. As previously alluded to, despite the theoretical relative resistance of streptococcal species to quinolones, clinical practice has not revealed a poor response to topica..