colistin and Corneal-Ulcer

To evaluate the antifungal activity of a fixed antibiotic combination (AC) containing tetracycline (TET), chloramphenicol (CAF), and colistimethate sodium (CS).. In vitro: Candida ATCC and clinical strains were used. The minimum inhibitory concentrations (MICs) of AC and of each antibiotic were determined. Fluconazole (FLC) was tested for comparison. Time-killing curves of selected strains were performed. Ex vivo keratitis: corneas were injected intrastromally with the selected strains. After the injection, corneas were divided into groups of treatments: AC, FLC, or saline. Then, the tissues were analyzed for colony-forming units per gram (CFU/g). Propidium iodide (PI) and MitoTracker (MTR) staining were used to investigate the mode of action.. Values of MIC required to inhibit the growth of 90% of organisms for the antibiotics alone were higher than FLC. However, their activity was enhanced when used in combination against Candida yeasts. Time-killing curves showed that at 24 hours, AC reduced the load of both strains of approximately 1 Log10 CFU/g compared with the initial inoculum (P < 0.0001). This effect was also significant versus FLC. In ex vivo, AC was effective in decreasing the loads of both strains by 4 Log10 CFU/g with respect to the control. Moreover, it showed higher activity than FLC against Candida albicans ATCC 10231 (1 Log10 CFU/g, P < 0.01 versus control). PI staining demonstrated that CS changed the membrane's permeability, whereas MTR staining demonstrated that TET or CAF altered mitochondrial function. The cells treated with AC and stained showed both effects.. In this study, AC showed antifungal efficacy versus Candida spp.; this activity can be due to the synergistic effects of antibiotics in it.

Topics: Animals; Anti-Bacterial Agents; Candida albicans; Candidiasis; Chloramphenicol; Colistin; Colony Count, Microbial; Corneal Ulcer; Drug Combinations; Drug Resistance, Fungal; Drug Synergism; Eye Infections, Fungal; Microbial Sensitivity Tests; Ophthalmic Solutions; Rabbits; Tetracycline; Treatment Outcome

Emergence of multi-drug resistant (MDR), extensively drug resistant (XDR), and pan-drug resistant (PDR) strains of Pseudomonas aeruginosa pose a significant therapeutic challenge. Managing XDR and PDR Pseudomonas aeruginosa keratitis would be extremely difficult due to paucity of safe and effective topical medications. We aim to describe the clinical features, risk factors, and outcome of XDR and PDR Pseudomonas aeruginosa keratitis.. A retrospective chart review of consecutive cases of XDR and PDR Pseudomonas aeruginosa keratitis were identified from Ocular Microbiology Department. XDR and PDR were defined based on criteria established by Centers for Disease Control and European Centre for Disease Prevention and Control. The following data was collected: age, gender, occupation, symptom duration, systemic and ocular risk factors, infiltrate characteristics, antimicrobial susceptibility, complications, surgical interventions, presenting, and final visual acuity and final outcome. Complete success was defined as resolution of the infiltrate with scar formation on medical treatment alone. Partial success was the resolution following tissue adhesive application. Failure was an inadequate response to medical therapy with progressive increase in infiltrate, corneal melting, and/or perforation necessitating one or more therapeutic penetrating keratoplasties or evisceration.. Fifteen eyes of 13 patients were included. Seven (53.8 %) were male with left eye involvement in nine (60 %) cases. Most common risk factors were bandage contact lens (6, 40 %), topical steroids (5, 33.3 %), previous therapeutic graft (4, 26.6 %), and ocular surface disorder (OSD) following Stevens Johnson Syndrome (SJS) (4, 26.6 %). Of 15 isolates, six (40 %) were sensitive only to imipenem, three (20 %) to colistin, two (13.3 %) to neomycin, one (6.7 %) each to imipenem and colistin, imipenem and ceftazidime, and azithromycin respectively. One isolate was resistant to all antibiotics. Complete success was noted in two (16.67 %), partial success in three (25 %) and failure in seven (58.33 %) eyes. Five (33.3 %) eyes healed on imipenem (three eyes), azithromycin (one eye), and imipenem and colistin (one eye).. XDR and PDR Pseudomonas aeruginosa keratitis are extremely difficult to treat. Globe salvage was possible in all cases; however, more than half required therapeutic grafts. Close monitoring of patients with known ocular and systemic factors is warranted.

Topics: Anti-Bacterial Agents; Ciprofloxacin; Colistin; Corneal Ulcer; Drug Resistance, Multiple, Bacterial; Eye Infections, Bacterial; Female; Humans; Imipenem; Keratoplasty, Penetrating; Male; Microbial Sensitivity Tests; Ofloxacin; Pseudomonas aeruginosa; Pseudomonas Infections; Retrospective Studies; Risk Factors; Visual Acuity

The purpose was to evaluate the clinical outcome in multi-drug resistant Pseudomonas aeruginosa (MDR-PA) bacterial keratitis and report the successful use of an alternative antibiotic, topical colistimethate in some of them. The medical records of 12 culture-proven MDR-PA keratitis patients, all exhibiting in vitro resistance by Kirby-Bauer disc diffusion method to ≥ three classes of routinely used topical antibiotics were reviewed. Eight patients were treated with 0.3% ciprofloxacin or ofloxacin, 1 patient with 5% imipenem/cilastatin and 3 patients with 1.6% colistimethate. The outcomes in 8 eyes treated with only fluoroquinolones were evisceration in 4 eyes, therapeutic corneal graft in 1 eye, phthisis bulbi in 1 eye, and no improvement in 2 eyes. The eye treated with imipenem/cilastin required a therapeutic corneal graft. All the three eyes treated with 1.6% colistimethate healed. Colistimethate may prove to be an effective alternative antibiotic in the treatment of MDR-PA keratitis.

Topics: Administration, Topical; Adolescent; Adult; Anti-Bacterial Agents; Child; Colistin; Corneal Ulcer; Drug Resistance, Multiple, Bacterial; Eye Infections, Bacterial; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Pseudomonas aeruginosa; Pseudomonas Infections; Retrospective Studies; Visual Acuity

The aim of this study was to report the utility of topical colistin in multi-drug resistant Pseudomonas aeruginosa bacterial keratitis.. Retrospective interventional case series included 8 patients with culture-proven multi-drug resistant P. aeruginosa (MDR-PA) bacterial keratitis who presented from June 2011 to January 2012 and were treated with colistin 0.19% as monodrug therapy. Clinical/microbiological data were collected from medical records. All patients underwent microbiological corneal scraping. Intensive half-hourly therapy with broad-spectrum antibiotics was changed to colistin 0.19% when antibiotic sensitivity reports were available. The outcome was a "complete success" if resolution of infection occurred with scar formation without any subsequent recurrence up to 2 weeks and "partial success" if it also required a cyanacrylate glue application. The outcome was a "failure" if the patient required a therapeutic graft or if the infection could not be controlled and the eye needed evisceration.. The mean age was 45 ± 16 years; the M:F ratio was 1:1. Seven patients had a history of ocular surgery. The mean size of the infiltrate was 15.41 ± 22.2 mm and was full thickness in 5 patients. Success was achieved in 7 out of 8 patients, and the infiltrate gradually decreased with resolution of infection in a mean duration of 30.5 ± 16 days. Complete and partial success were noted in 4 and 3 patients, respectively. The final visual acuity was 20/60 or better in 4 patients. One patient required a sclerocorneal patch graft. No complications of topical colistin were noticed.. The early use of topical colistin 0.19% was found to be a safe and effective alternative in the management of multi-drug resistant P. aeruginosa bacterial keratitis.

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Bacterial Agents; Colistin; Corneal Ulcer; Drug Resistance, Multiple, Bacterial; Eye Infections, Bacterial; Female; Humans; Male; Middle Aged; Ophthalmic Solutions; Pilot Projects; Pseudomonas Infections; Retrospective Studies; Visual Acuity

Two rare species of Pseudomonas were isolated from corneal ulcers in two patients. In the first case P. acidovorans was isolated and suspected as the primary pathogenic microorganism in human disease. In the second case P. stutzeri was isolated from ocular sources, but this is the first report of its role in causing corneal disease. The patient in the second case had a scarred cornea, possibly caused by a previous herpetic infection, and this may have been a predisposing factor to the development of the infection by P. stutzeri. Susceptibility studies of both organisms revealed sensitivity to a wide range of antibiotics but resistance to carbenicillin, a drug currently used in the treatment of infections from P. aeruginosa.

Topics: Abscess; Aged; Anti-Bacterial Agents; Carbenicillin; Colistin; Corneal Ulcer; Edema; Female; Gentamicins; Humans; Intraocular Pressure; Male; Middle Aged; Penicillin Resistance; Pseudomonas; Pseudomonas Infections

Fifty organisms of Pseudomonas aeruginosa were injected intralamellarly in both eyes of 60 albino rabbits. Twenty-four hours later, all eyes were graded and stratified into six groups of ten rabbits with equivalent infections. Treatment was begun with gentamicin alone or 0.3% polymyxin B alone, and in combination with acetylcysteine, 0.3M edetate disodium, and 2.500 units/ml of heparin sodium, four times daily. We also compared topical colistin and colistin and topical heparin. After two weeks, those corneas treated with polymyxin B and topical heparin showed a reduction in ulceration, corneal thinning, and descemetocele formation compared to those treated with polymyxin B alone. Based on these studies, heparin was administered topically, four times daily, to three patients with Pseudomonas-induced corneal ulcers in addition to antibiotics. Before treatment all corneas showed evidence of corneal liquefaction and two of the corneas were in imminent danger of perforation. After therapy, no corneas perforated; one patient recovered visual acuity of 6/9 (20/30), one patient recovered visual acuity of 6/6 (20/20) after keratoplasty, and the third has a vascularized leukoma.

Topics: Acetylcysteine; Administration, Topical; Adult; Animals; Colistin; Corneal Ulcer; Drug Therapy, Combination; Edetic Acid; Gentamicins; Heparin; Humans; Male; Middle Aged; Polymyxins; Pseudomonas aeruginosa; Pseudomonas Infections; Rabbits

Topics: Animals; Colistin; Corneal Ulcer; Disease Models, Animal; Drug Combinations; Gentamicins; Ophthalmic Solutions; Pseudomonas Infections; Rabbits; Sulfates; Wound Healing

Topics: Adult; Anti-Bacterial Agents; Colistin; Corneal Ulcer; Cross Infection; Eye Foreign Bodies; Gentamicins; Humans; Male; Middle Aged; Polymyxins; Pseudomonas aeruginosa; Pseudomonas Infections

Topics: Adult; Anti-Bacterial Agents; Carbenicillin; Colistin; Corneal Ulcer; Eye Diseases; Female; Gentamicins; Humans; Male; Middle Aged; Penicillin Resistance; Polymyxins; Pseudomonas aeruginosa; Pseudomonas Infections

Topics: Adolescent; Adult; Aged; Alkalies; Child; Chloramphenicol; Colistin; Cornea; Corneal Ulcer; Eye Burns; Eye Diseases; Female; Heparin; Humans; Keratitis; Keratitis, Dendritic; Keratoconjunctivitis; Male; Middle Aged; Polymyxins; Postoperative Complications; Retinal Detachment

Topics: Anti-Bacterial Agents; Colistin; Corneal Ulcer; Gentamicins; Humans; Microbial Sensitivity Tests; Penicillins; Pseudomonas aeruginosa; Pseudomonas Infections

Topics: Adolescent; Adult; Chloramphenicol; Colistin; Corneal Ulcer; Dacryocystitis; Eye Injuries; Female; Humans; Infant; Male; Microbial Sensitivity Tests; Ophthalmic Solutions; Sulfonic Acids

Topics: Animals; Colistin; Cornea; Corneal Opacity; Corneal Ulcer; Gentamicins; Injections; Polymyxins; Pseudomonas Infections; Rabbits

Topics: Animals; Colistin; Conjunctiva; Contact Lenses; Cornea; Corneal Ulcer; Injections; Photography; Pseudomonas aeruginosa; Pseudomonas Infections; Rabbits; Time Factors; Wound Healing

Topics: Adolescent; Adult; Aged; Animals; Anti-Bacterial Agents; Bacteria; Child; Child, Preschool; Colistin; Cornea; Corneal Ulcer; Dogs; Drug Resistance, Microbial; Drug Synergism; Edema; Eye Diseases; Female; Humans; Infant; Male; Middle Aged; Ophthalmic Solutions; Panophthalmitis; Pseudomonas; Pseudomonas Infections; Rats; Staphylococcal Infections; Staphylococcus

Topics: Adolescent; Adult; Antisepsis; Colistin; Conjunctivitis; Corneal Ulcer; Erythromycin; Female; Humans; Infant; Male; Ointments; Ophthalmic Solutions; Preoperative Care; Pseudomonas Infections

Topics: Adult; Aged; Colistin; Corneal Ulcer; Eye Injuries; Female; Humans; Male; Middle Aged; Polymyxins; Pseudomonas Infections

Topics: Adolescent; Adrenal Cortex Hormones; Colistin; Corneal Ulcer; Female; Humans; Polymyxins; Pseudomonas Infections

Topics: Adrenal Cortex Hormones; Antifungal Agents; Colistin; Corneal Ulcer; Diagnosis, Differential; Herpes Zoster Ophthalmicus; Humans; Idoxuridine; Keratitis; Keratoconus; Mycoses; Natamycin; Nystatin; Polymyxins

Topics: Colistin; Corneal Ulcer; Drug Therapy; Geriatrics; Humans; Pseudomonas aeruginosa; Pseudomonas Infections; Toxicology

Topics: Abscess; Adolescent; Animals; Child; Colistin; Cornea; Corneal Ulcer; Corynebacterium; Dacryocystitis; Drug Therapy; Geriatrics; Humans; Hydrogen-Ion Concentration; Infant; Ophthalmology; Orbit; Osmosis; Pseudomonas Infections; Rabbits; Research; Staphylococcal Infections; Streptococcal Infections; Ulcer; Uveitis

Topics: Animals; Colistin; Corneal Ulcer; Humans; Lagomorpha; Male; Pseudomonas; Pseudomonas Infections; Rabbits; Sulfanilamide; Sulfanilamides; Sulfonamides

Topics: Animals; Colistin; Corneal Ulcer; In Vitro Techniques; Lagomorpha; Pharmacology; Pseudomonas; Pseudomonas Infections; Rabbits; Research; Sulfanilamide; Sulfanilamides; Sulfonamides