Role of steroids in the treatment of bacterial keratitis

Sotiria Palioura, Christopher R Henry, Guillermo Amescua, Eduardo C AlfonsoDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA Abstract: Bacterial keratitis can lead to severe visual impairment from corneal ulceration, subs...

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Autores principales:	Palioura S, Henry CR, Amescua G, Alfonso EC
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	topical corticosteroids corneal ulcer eye infection antibiotic endophthalmitis perforation Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/367cd6d456ad4b73a01fb07c88b61b67
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spelling	oai:doaj.org-article:367cd6d456ad4b73a01fb07c88b61b672021-12-02T06:34:34ZRole of steroids in the treatment of bacterial keratitis1177-5483https://doaj.org/article/367cd6d456ad4b73a01fb07c88b61b672016-01-01T00:00:00Zhttps://www.dovepress.com/role-of-steroids-in-the-treatment-of-bacterial-keratitis-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Sotiria Palioura, Christopher R Henry, Guillermo Amescua, Eduardo C AlfonsoDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA Abstract: Bacterial keratitis can lead to severe visual impairment from corneal ulceration, subsequent scarring, and possible perforation. The mainstay of treatment is topical antibiotics, whereas the use of adjunctive topical corticosteroid drops remains a matter of debate. Herein, we review the rationale for and against the use of topical corticosteroids and we assess their effectiveness and safety in the published randomized controlled trials that have evaluated their role as adjunctive therapy for bacterial corneal ulcers. In the largest study to date, the Steroids for Corneal Ulcers Trial, topical corticosteroid drops were neither helpful nor harmful for the 500 participants as a whole. However, subgroup analyses suggested that topical corticosteroids may be beneficial upon early administration (within 2–3 days after starting antibiotics) for more central corneal ulcers with poorer vision at presentation, for invasive Pseudomonas strains, and for non-Nocardia ulcers. These results are discussed within the limitations of the study.Keywords: topical corticosteroids, corneal ulcer, eye infection, antibiotic, endophthalmitis, perforationPalioura SHenry CRAmescua GAlfonso ECDove Medical Pressarticletopical corticosteroidscorneal ulcereye infectionantibioticendophthalmitisperforationOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2016, Iss Issue 1, Pp 179-186 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	topical corticosteroids corneal ulcer eye infection antibiotic endophthalmitis perforation Ophthalmology RE1-994
spellingShingle	topical corticosteroids corneal ulcer eye infection antibiotic endophthalmitis perforation Ophthalmology RE1-994 Palioura S Henry CR Amescua G Alfonso EC Role of steroids in the treatment of bacterial keratitis
description	Sotiria Palioura, Christopher R Henry, Guillermo Amescua, Eduardo C AlfonsoDepartment of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA Abstract: Bacterial keratitis can lead to severe visual impairment from corneal ulceration, subsequent scarring, and possible perforation. The mainstay of treatment is topical antibiotics, whereas the use of adjunctive topical corticosteroid drops remains a matter of debate. Herein, we review the rationale for and against the use of topical corticosteroids and we assess their effectiveness and safety in the published randomized controlled trials that have evaluated their role as adjunctive therapy for bacterial corneal ulcers. In the largest study to date, the Steroids for Corneal Ulcers Trial, topical corticosteroid drops were neither helpful nor harmful for the 500 participants as a whole. However, subgroup analyses suggested that topical corticosteroids may be beneficial upon early administration (within 2–3 days after starting antibiotics) for more central corneal ulcers with poorer vision at presentation, for invasive Pseudomonas strains, and for non-Nocardia ulcers. These results are discussed within the limitations of the study.Keywords: topical corticosteroids, corneal ulcer, eye infection, antibiotic, endophthalmitis, perforation
format	article
author	Palioura S Henry CR Amescua G Alfonso EC
author_facet	Palioura S Henry CR Amescua G Alfonso EC
author_sort	Palioura S
title	Role of steroids in the treatment of bacterial keratitis
title_short	Role of steroids in the treatment of bacterial keratitis
title_full	Role of steroids in the treatment of bacterial keratitis
title_fullStr	Role of steroids in the treatment of bacterial keratitis
title_full_unstemmed	Role of steroids in the treatment of bacterial keratitis
title_sort	role of steroids in the treatment of bacterial keratitis
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/367cd6d456ad4b73a01fb07c88b61b67
work_keys_str_mv	AT paliouras roleofsteroidsinthetreatmentofbacterialkeratitis AT henrycr roleofsteroidsinthetreatmentofbacterialkeratitis AT amescuag roleofsteroidsinthetreatmentofbacterialkeratitis AT alfonsoec roleofsteroidsinthetreatmentofbacterialkeratitis
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Role of steroids in the treatment of bacterial keratitis

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