The use of antibiotics agents in ocular infection

• Main Author: Safiee, A.
• Published: University College London (University of London) 2008
• Subjects: 617.7
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.719118

Eye disease can cause discomfort and anxiety in patients, with the ultimate risk of loss of vision or even facial disfigurement. The unique structure of the human eye as well as exposure of the eye directly to the environment renders it vulnerable to a number of uncommon infectious diseases caused by bacteria, fungi and parasites. The driving force for the development of newer anti-infectives is almost always the inevitable emergence of bacterial resistance to antibiotics following widespread clinical, veterinary, and agricultural (growth promoter in chickens, pigs, and feedlot cattle) usage. The pharmaceutical industry has continuously met this need by modifying existing antibiotics and developing newer antibiotics. These successful efforts have produced the wide variety of currently available drug classes of antibiotics beta lactams (penicillins, carbapenems, cepahalosporins), glycopeptides, macrolides, ketolides, aminoglycosides, fluoroquinolones, oxazolidinones, and others . There are, however, still several serious and potentially blinding eye diseases that lack adequate and effective treatment. Despite coverage with broad-spectrum antibiotics, visual loss remains a common result (1,2). The outcome of the most severe infections is determined by several factors, such as the responsible pathogen, the patient's age, the therapy chosen, or the condition of the eye upon presentation (3). The most important factor, however, seems to be the duration between infection and treatment. Clinical and experimental studies have firmly established that delay in therapy increases the risk of poor visual outcome, especially in severe cases. Early and accurate diagnosis of the responsible pathogen is, therefore, essential for effective treatment. However, when ocular infection is suspected, the pathogen is typically not known, so the choice of antimicrobial agent must be made empirically. Unfortunately, clinical features of infection and culture results do frequently not correlate adequately to guide the choice of antibiotics upon presentation (4). The objective of the present work was therefore to compile and review the available information on bacterial eye diseases as well as the current drugs and therapies and their limitations. It is hoped that this may assist both clinicians and research scientists in improving the diagnosis and treatment of these diseases. To this end, the present study : 1- presents an overview of the eye's physiology and of the current knowledge of microbes infecting the eye 2- reviews the currently available therapies for eye infections 3- introduces a handbook for ophthalmologists on antimicrobial drugs including dosage, ingredient and possible drug-drug interaction 4- examines two promising avenues for overcoming the present medical challenges posed by eye infections: more sensitive tools for early and more accurate diagnosis of microbial infections and better delivery systems for drug targeting.