tetracycline and Keratitis

Seventy patients with rosacea were treated with systemic tetracycline for 6 months. Sixty-eight of them cleared with treatment. After withdrawal of the drug seventeen relapsed immediately and the overall relapse rate over 4 years was 69%. The serum tetracycline levels were not significantly different in two patients who failed to respond. Six patients had rosacea keratitis and responded dramatically within 1 month. Symptoms recurred as the drug was withdrawn. It is suggested that rosacea patients with keratitis should receive early and prolonged tetracycline medication.

Topics: Clinical Trials as Topic; Female; Follow-Up Studies; Humans; Keratitis; Male; Middle Aged; Recurrence; Rosacea; Tetracycline

A controlled chemotherapy trial of trachoma was carried out in a Tunisian oasis among schoolchildren with active disease. We compared 1% tetracycline ointment (79 patients) or 1% rifampicin ointment (76 patients) with 5% boric acid ointment (79 patients). Medications were administered twice daily, six days a week, for ten weeks. Slit-lamp examinations by three ophthalmologists were made independently before treatment as well as five, 19, and 39 weeks after treatment. Bacteriologic cultures were taken during treatment as were smears to detect trachoma agent at each clinical examination. Five weeks after treatment, the intensity of conjunctival disease in the tetracycline and rifampicin groups was reduced significantly when compared with boric acid, but at 19 weeks this suppression was found only in the tetracycline group. Ocular bacterial pathogens were eliminated almost entirely in the two antibiotic groups during treatment. The initial prevalence of trachoma (29to 31%) was significantly reduced in the two antibiotic-treated groups at five weeks and 19 weeks after treatment. The prevalence of trachoma was equally low (7%) in all three groups following retreatment with tetracycline. Although both antibiotics were effective, rifampicin offered no advantage over tetracycline in this trial. Recurrent disease in this school-based treatment study probably was due to reinfection from younger siblings at home. While systematic, community-wide, antibiotic treatment programs are not always possible in countries where trachoma is endemic, limited antibiotic therapy programs should be continued in these areas to reduce the intensity and prevalence of trachoma, even though the disease cannot be eradicated.. In this study, the authors compared topically applied tetracycline or rifampicin ointment with boric acid ointment administered for 10 weeks for its effect on endemic trachoma. 234 children with active disease were included in the treatment study. Those with the active disease were divided into 2 groups containing equal numbers each of the 3 intensity categories. Then each group was assigned to 1 of 3 treatment categories. Medication was administered twice daily over a single 3-hour class period and a 70-day course of follow-up therapy with 1% tetracycline was provided once daily for all the children 25 weeks after completion of the initial treatment. 62 (26.5%) had severe trachoma and 133 (56.8%) had trachoma of moderate intensity. In March 1972, 5 weeks after treatment completion, the trachoma in the 2 groups treated with antibiotics was less severe compared with the boric acid group. However, by June 1972, only the tetracycline group had less active trachoma than the boric acid treated group. By this time, also, the 3 groups were equally improved. Following the 2nd course of tetracycline treatment 25-35 weeks after the initial trial, there were no differences in any of the groups. 2 courses of therapy, therefore, were no more advantageous than 1. In Giemsa-stained smears prior to treatment, the prevalence of positive smears for Chlamydia agent were similar in the 3 groups; following treatment, prevalence had dropped to 7% overall and then after retreatment, there were rarely any cases in any of the treated groups. While the 2 antibodies were significantly better than boric acid, rifampicin did not seem to offer any significant advantages over tetracycline. The prevalence of trachoma agent appeared to change more readily than the clinical disease. Clearly the pattern of disease intensity and microbial infection displayed a seasonal cycle thatmust be considered when evaluating antibiotic treatment efficacy. The prevalence of trachoma decreases with age and that, along with the seasonality, contribute to the disease intensity. In this study, treatment did alter the disease temporarily but did not affect its course in the long run since environmental factors which originally produced the disease had not changed. Only communitywide chemotherapy would have a significant effect. However, antibiotic treatment is necessary to reduce the occurrence of later complications.

Topics: Administration, Topical; Animals; Boric Acids; Child; Chlamydia; Clinical Trials as Topic; Conjunctiva; Humans; Keratitis; Ointments; Rifampin; Sheep; Tetracycline; Trachoma; Tunisia

Aspergillus species produces a wide spectrum of fungal diseases like endophthalmitis and fungal keratitis ophthalmologically, but there has been no report about blepharitis caused by Aspergilus flavus to date. Herein, we report a 61-year-old ethnic Han Taiwanese male who had suffered from pain with burning and foreign body sensation after an insect bite on his left eye. Specimens from bilateral eyelids suggested infection of A. flavus, whereas corneal scraping showed the presence of Gram-negative bacteria. He was admitted for treatment of infectious keratitis with topical antibiotic and antifungal eye drops. Two weeks after discharge, recurrent blepharitis and keratitis of A. flavus was diagnosed microbiologically. Another treatment course of antifungal agent was resumed in the following 6 months, without further significant symptoms in the following 2 years. Collectively, it is possible for A. flavus to induce concurrent keratitis and blepharitis, and combined treatment of keratitis as well as blepharitis is advocated for as long as 6 months to ensure no recurrence.

Topics: Anti-Bacterial Agents; Antifungal Agents; Aspergillus flavus; Blepharitis; Eye Infections, Fungal; Follow-Up Studies; Humans; Keratitis; Male; Middle Aged; Natamycin; Taiwan; Tetracycline

Topics: Adult; Colitis, Ulcerative; Conjunctivitis; Dexamethasone; Drug Therapy, Combination; Functional Laterality; Granulomatous Disease, Chronic; Humans; Keratitis; Male; Ofloxacin; Tetracycline; Visual Acuity

To report a case of Lyme disease that presented with a single nummular unilateral interstitial keratitis.. Case report and review of the literature.. A 57-year-old black man who had contact with freshly killed deer had a chief complaint of foreign-body sensation in his right eye (OD) that had been diagnosed and treated for herpes simplex stromal keratitis. The patient underwent a systemic workup for interstitial keratitis. All results including RPR and MHA-TP were negative except for Lyme antibody titer (enzyme-linked immunosorbent assay [ELISA]) 178 U/ml (normal, <159 U/ml).. Interstitial keratitis from Lyme disease has been regarded as a bilateral disease in the literature. We present this infrequent ocular manifestation of Lyme disease as a rare single nummular unilateral presentation.

Topics: Anti-Bacterial Agents; Antibodies, Bacterial; Borrelia burgdorferi Group; Corneal Stroma; Diagnosis, Differential; Enzyme-Linked Immunosorbent Assay; Eye Infections, Bacterial; Follow-Up Studies; Humans; Keratitis; Lyme Disease; Male; Middle Aged; Tetracycline

Clarithromycin, a macrolide antibiotic not previously tested against the common causes of bacterial keratitis, was analyzed for its effectiveness in reducing the number of viable bacteria in a Staphylococcus keratitis model. An in vivo comparison of the effectiveness of clarithromycin to erythromycin, minocycline, and tetracycline for three strains of Staphylococcus aureus was done.. Rabbit eyes were intrastromally injected with 100 colony forming units of one of three strains of S. aureus. Two strains were methicillin-sensitive (ATCC 25923 and MSSA 309) and one strain methicillin-resistant (COL). Eyes were treated every 30 minutes with 0.3% clarithromycin, erythromycin, tetracycline, or minocycline from 4 to 9 hours postinfection. The number of colony forming units (CFU) per cornea in all eyes was determined at 10 hours postinfection.. Vehicle-treated and untreated eyes (controls) contained over 6 logs of CFU per cornea, a value significantly higher than any of the antibiotic-treated eyes (P < or = 0.0001). Clarithromycin or erythromycin therapy significantly decreased the number of CFU per cornea by approximately 5 logs in the eyes infected with the methicillin-sensitive strains and by approximately 4 logs in the eyes infected with the methicillin-resistant strain. Tetracycline and minocycline were also successful in treating these strains, but overall showed less effectiveness than clarithromycin and erythromycin.. Clarithromycin proved to be an effective ocular medication for the therapy of experimental S. aureus keratitis. The effectiveness of clarithromycin in this model and its known effectiveness for a variety of bacterial pathogens suggests a role for this drug as a useful ocular antibiotic.

Topics: Animals; Anti-Bacterial Agents; Clarithromycin; Colony Count, Microbial; Erythromycin; Keratitis; Minocycline; Rabbits; Staphylococcal Infections; Staphylococcus aureus; Tetracycline

Two cases of follicular conjunctivitis due to Chlamydia trachomatis followed by punctate epithelial keratitis are described. Both cases were initially treated with either oral tetracycline or doxycycline with resolution of the follicles. These two patients subsequently had recurrent, bilateral grayish lesions at various levels in the corneal epithelium that stained in a punctate fashion with fluorescein. There was anterior stromal edema associated with some of these lesions in one case. The lesions were confined mostly to the central cornea. These recurrent lesions were unassociated with a conjunctival reaction, were unresponsive to oral tetracycline, but were exquisitely responsive to low doses of topical steroids. Chlamydial conjunctivitis and the associated keratitis typically shows no response or actual exacerbation of symptoms with topical steroids, and the keratitis shows a predilection for the upper half of the cornea. These patients demonstrate that chlamydial keratoconjunctivitis might result in a clinical appearance consistent with Thygeson's superficial punctate keratitis.

Topics: Adolescent; Adult; Chlamydia Infections; Conjunctivitis; Doxycycline; Eye Infections, Bacterial; Female; Humans; Keratitis; Tetracycline

The incidence of Lyme disease has been increasing at alarming rates in recent years. Being the most commonly reported tickborne bacterial disease in the United States, it now outnumbers Rocky Mountain spotted fever by a ratio of almost 2:1. It is a multisystem illness and can manifest itself with dermatologic, neurologic, cardiac and rheumatologic involvement. The ocular complications of Lyme disease can present as one of the more ominous signs during the course of the illness. The detection of the disease and proper referral by the optometrist may permit more appropriate treatment, and thus, a better prognosis of the illness.

Topics: Bites and Stings; Borrelia Infections; Conjunctivitis; Eye Diseases; Humans; Keratitis; Lyme Disease; Optic Nerve Diseases; Papilledema; Penicillins; Tetracycline; Uveitis

In four patients with an adult chlamydial ophthalmia small, marginal corneal abscesses were detected. These corneal abscesses were associated with unilateral papillary and follicular conjunctivitis and punctate keratitis. In these patients no bacteria was isolated from the abscesses, but Chlamydia trachomatis was isolated from materials collected from the abscesses and from the conjunctival swabbings. In addition all patients had microbiologically proved concomitant chlamydial genital infections. The clinical signs resolved after topical treatment with rifampicin or tetracycline eye ointment for six weeks or systemic treatment with tetracycline for two weeks. Because of concomitant chlamydial genital infection it is advisable to treat patients with adult chlamydial ophthalmia with systemic tetracycline and to refer these patients and their consorts for investigation and treatment of their genital infection.

Topics: Abscess; Adult; Chlamydia Infections; Chlamydia trachomatis; Conjunctivitis, Inclusion; Corneal Diseases; Female; Humans; Keratitis; Male; Middle Aged; Rifampin; Tetracycline

The in vivo antibacterial effectiveness in the rabbit cornea of a number of commercially available ophthalmic antibiotic preparations was determined against a single strain of penicillinase-producing Staphylococcus aureus isolated from a human corneal ulcer. Each antibiotic was instilled topically at hourly intervals, and the number of residual viable organisms in the cornea subsequently was ascertained. In vivo measurements demonstrated that five antibiotics--neomycin sulfate, gentamicin sulfate, erythromycin, tetracycline hydrochloride, and chlortetracycline hydrochloride--were equally effective in suppressing growth of the strain of S aureus studied. Therapeutic results were the same whether the corneal epithelium was present of absent for each of the drugs studied. With one exception (chloramphenicol), there was excellent correlation between in vivo and in vitro findings.

Topics: Administration, Topical; Animals; Anti-Bacterial Agents; Chlortetracycline; Disease Models, Animal; Erythromycin; Gentamicins; Humans; In Vitro Techniques; Keratitis; Neomycin; Ophthalmic Solutions; Rabbits; Staphylococcal Infections; Staphylococcus aureus; Tetracycline

Topics: Humans; Keratitis; Rosacea; Tetracycline

In a 15-year-old boy a culture-proved keratitis after a corneal perforation healed without antifungal agents after corneal suturing and application of tissue glue. Eight months later a posterior corneal abscess developed. Diagnostic and therapeutic penetrating keratoplasty was performed when the lesion failed to respond to pimaricin. Cultures were positive for Acremonium potronii, the same fungus isolated from the original corneal laceration eight months previously. To our acknowledge, this is the first case report of a central corneal ulcer or abscess due to this specific organism.

Topics: Adolescent; Atropine; Bacitracin; Corneal Injuries; Corneal Ulcer; Cyanoacrylates; Eye Injuries; Gentamicins; Histamine H1 Antagonists; Humans; Keratitis; Male; Mycoses; Natamycin; Neomycin; Polymyxins; Prednisolone; Recurrence; Tetracycline; Wound Healing

An 11-year-old girl had hyperacute conjunctivitis but was lost to follow-up until nine days later when she returned with a corneal perforation and iris prolapse. A smear at that time showed Gram-negative intracellular diplococci, but subsequent bacteriological study revealed the causative organism to be Mima polymorpha. This apparently is the first documented case of corneal perforation due to Mimeae, and emphasizes that Mimeae can be completely indistinguishable, clinically and on smear, from infection caused by Neisseria. Only a high index of suspicion and the proper bacterial cultures can prevent a possible tragic misdiagnosis.

Topics: Acinetobacter Infections; Child; Conjunctivitis; Eye Diseases; Female; Humans; Iris; Keratitis; Microbial Sensitivity Tests; Penicillin G; Tetracycline

Topics: Chloramphenicol; Conjunctivitis; Contact Lenses; Contact Lenses, Hydrophilic; Delayed-Action Preparations; Diffusion; Eye Diseases; Humans; Keratitis; Methods; Spectrophotometry; Tetracycline; Time Factors

Topics: Animals; Anti-Bacterial Agents; Antiviral Agents; Child; Corneal Ulcer; Eye Injuries; Glucocorticoids; Humans; Keratitis; Male; Nocardia; Nocardia Infections; Rabbits; Species Specificity; Sulfonamides; Tetracycline

Topics: Atropine; Child, Preschool; Corneal Dystrophies, Hereditary; Eye Diseases; Female; Humans; Keratitis; Kwashiorkor; Lens, Crystalline; Tetracycline; Vitamin A Deficiency

Topics: Female; Humans; Keratitis; Middle Aged; Rocky Mountain Spotted Fever; Tetracycline; Uvea

Topics: Anthelmintics; Anti-Bacterial Agents; Antifungal Agents; Aqueous Humor; Chloramphenicol; Chlortetracycline; Conjunctivitis; Dihydrostreptomycin Sulfate; Drug Resistance; Drug Resistance, Microbial; Endophthalmitis; Escherichia coli Infections; Helminthiasis; Keratitis; Keratitis, Dendritic; Lens, Crystalline; Manometry; Mycoses; Oxytetracycline; Penicillins; Staphylococcal Infections; Tetracycline; Virus Diseases

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Cortisone; gamma-Globulins; Humans; Idoxuridine; Immunization, Passive; Interferons; Keratitis; Ophthalmology; Surgical Procedures, Operative; Tetracycline; Vaccinia; Vaccinia virus

Topics: Anti-Bacterial Agents; Drug Combinations; Humans; Hydrocortisone; Keratitis; Ophthalmology; Oxytetracycline; Protein Synthesis Inhibitors; Tetracycline