Antimicrobials

Antimicrobials in ocular infections

The treatment of ocular infections depends on the microorganism involved. The most important ocular infections and their therapy are mentioned here. For the mechanism of action you are referred to the section on infectious diseases. First line therapy for a bacterial conjunctivitis or blepharitis is fusidic acid, tetracycline (see tetracyclines), or chloramfenicol. These drugs are effective against staphylococcal and streptococcal bacteria. Chloramfenicol has the advantage of penetrating well in the anterior chamber. The macrolideerythromycin is effective against gram-positive and some gram-negative microorganisms. Keratitis and Pseudomonas infections can be treated with quinolones (ciprofloxacin,

norfloxacin, or ofloxacin) and with reserve aminoglycosides gentamicin and tobramycin. Acyclovir (see acyclovir) is drug of choice for herpes simplex keratitis. In Chlamydia infections, tetracycline is drug of choice. Gonococcal infections are treated with penicillins. In general, the duration of antimicrobial therapy for ocular infections should not exceed two weeks, in order to reduce the development of resistance and risk of sensitization.