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January 1978

Topical Tobramycin Therapy of Experimental Pseudomonas Keratitis: An Evaluation of Some Factors That Potentially Enhance Efficacy

Author Affiliations

From the Infectious Diseases Division, Department of Pediatrics, Medical College of Wisconsin and Milwaukee Children's Hospital; and Cornea-External Eye Disease Unit, the Eye Institute and the Medical College of Wisconsin Department of Ophthalmology.

Arch Ophthalmol. 1978;96(1):123-125. doi:10.1001/archopht.1978.03910050079020

• We evaluated several therapeutic modifications in an attempt to improve efficacy of topical therapy with tobramycin of experimental Pseudomonas keratitis in guinea pigs. Removal of corneal epithelium enhanced efficacy of topical therapy with 0.3 mg/ml and 3 mg/ml tobramycin sulfate but did not influence therapy with 40 mg/ml or 400 mg/ml tobramycin. The highest concentration of antibiotic was the most effective; 7 of 12 infected corneas treated with 400 mg/ml tobramycin were sterile in 48 hours. Therapy begun soon after the infection was established, when there were relatively few organisms present, was more effective than therapy begun later, when there were many more bacteria in the cornea. Our results are consistent with a basic therapeutic concept. The most effective regimen is one that achieves the highest safe concentration of antibiotic at the site of infection as early in the course of infection as possible.