Topical Ciprofloxacin for Bacterial Corneal Ulcer

Abstract

Objective : To assess topical ciprofloxacin in patients with moderate severity of suspected bacterial corneal ulcers. Study Design : Randomized, controlled clinical trial. Setting : Inpatient at Siriraj Hospital. Participants : All patients with suspected corneal ulcers. Patients with fungal cause known before admission and an allergy to any medication, were excluded. Intervention : Topical ciprofloxacin 0.3 per cent or cefazolin (50 mg/ml) and fortified gentamicin (14 mg/ml) were given every 15 minutes for the first 6 hours, then every half hour on the first day, and every hour while awake till midnight until complete recovery without staining of fluorescein and no culture growth. Main Outcome Measures : The primary outcomes were the success rate and duration of the healing of the ulcer after treatment in each group. Results : Forty-one patients were enrolled. Twelve (70.6%) of 17 patients in the ciprofloxacin group were therapeutically successful while 15 (62.5%) of 24 patients in the control group showed similar outcome without a statistically significant difference. However, the mean duration for healing after treatment was not significantly different being 14.6 days in the control group and 15.6 days in the ciprofloxacin group. Visual improvement in the success cases of the control and ciprofloxacin groups was 46.7 per cent, and 66.7 per cent, respectively. Conclusion : Treatment with topical ciprofloxacin in suspected bacterial corneal ulcer should be considered as an alternative to standard therapy.