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How to Treat Keratitis Suppurative?



Medical Treatment:
Treat only if slit lamp access, otherwise refer. Scrape microscopic ulcer, culture and sensitivity and adjust the treatment accordingly.
Empirical therapy until the results of the culture are available:
* Ciprofloxacin 0.3 percent ophthalmic drops, 1 drop per hour for three days.
  • Then reduce 3-4 hourly drop frequency to 1 drop.
OR
* Ofloxacin 0.3%, ophthalmic drops, add 1 drop per hour for 3 days.
  • Then reduce 3-4 hourly drop frequency to 1 drop.
* Vancomycin 25 mg / mL, topical if gram positive infection.
  • Sodium chloride dilute 0.9 percent.
* Ceftazidim, 50 mg / mL, topical if gram negative infection.
  • Dilute with sterile water and artificial conservation- free tears.
If fungal infection:
* Natamycin 5 percent, ophthalmic drops, instill 1 drop for 3- 4 days 1- 2 hours per day. Use of specialists only).
  • Then reduce 3-4 hourly drop frequency to 1 drop.
  • Continue 14-21 days until infection is resolved.

When to refer:
  • No slit lamp access.
  • No microscopy, culture and sensitivity facilities.