2006
DOI: 10.1016/j.jcrs.2005.12.108
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Fourth-generation fluoroquinolone-resistant bacterial keratitis after refractive surgery

Abstract: We report the first 2 cases of bacterial keratitis resistant to fourth-generation fluoroquinolones after laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). The first patient had Pseudomonas aeruginosa keratitis after PRK despite treatment with moxifloxacin. The second patient was on gatifloxacin post-LASIK when she had methicillin-resistant Staphylococcus aureus (MRSA) keratitis diagnosed. In both cases, culture susceptibilities showed isolates resistant to moxifloxacin and gatifloxaci… Show more

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Cited by 86 publications
(49 citation statements)
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“…This is supported by published case reports [22][23][24] and in vitro experiments [25]. At a time when antibiotic-resistant micro-organisms are becoming an increasing problem [26][27][28][29][30][31][32][33][34][35][36], introduction of a new method to treat corneal infections would be of great benefit. It is crucial to elucidate whether the photo-activation of riboflavin using UVA at 365 nm is a method which is possible to incorporate in the treatment of microbial keratitis.…”
Section: Introductionmentioning
confidence: 79%
“…This is supported by published case reports [22][23][24] and in vitro experiments [25]. At a time when antibiotic-resistant micro-organisms are becoming an increasing problem [26][27][28][29][30][31][32][33][34][35][36], introduction of a new method to treat corneal infections would be of great benefit. It is crucial to elucidate whether the photo-activation of riboflavin using UVA at 365 nm is a method which is possible to incorporate in the treatment of microbial keratitis.…”
Section: Introductionmentioning
confidence: 79%
“…17,18 CXL may become a therapeutic alternative for managing antibiotic-resistant microbial infections. In 4 of our cases, the primary spot of infection was in the interface after LASIK.…”
Section: Discussionmentioning
confidence: 99%
“…[6][7][8] The successful treatment of mycobacterial keratitis with fourth-generation FQs has also been reported. [9][10][11] However, bacterial keratitis resistant to fourth-generation FQs has been found 12 and the prophylactic usage of moxifloxacin and gatifloxacin did not significantly lower the endophthalmitis rate after uncomplicated cataract surgery either. 13 Although the superiority of clinical efficacy between different FQs is still under evaluation, [14][15][16][17][18][19][20] controversial results exist that compare the toxicity of FQs towards the corneal epithelial cells.…”
Section: Introductionmentioning
confidence: 98%