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BRIEF COMMUNICATION
Year : 2016  |  Volume : 64  |  Issue : 2  |  Page : 153-157

Multi-drug resistant Pseudomonas aeruginosa keratitis and its effective treatment with topical colistimethate


Cornea and Anterior Segment Services, MGM Eye Institute, Raipur, Chhattisgarh, India

Correspondence Address:
Dr. Samrat Chatterjee
MGM Eye Institute, 5th Mile, Vidhan Sabha Road, Raipur - 492 007, Chhattisgarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.179721

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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.


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