Ofloxacin
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Ofloxacin Corneal deposits following ophthalmic administration: 6 case reports Six patients developed corneal deposits during ophthalmic administration of ofloxacin for infectious keratitis. A 51-year-old man had an infected corneal abrasion secondary to corneal basement membrane dystrophy. Over 4 days, he received topical chloramphenicol ointment followed by intensive ofloxacin [dosage not stated], cyclopentolate and subsequently intensive gentamicin. On day 4, corneal toxicity and deposits were observed and ofloxacin and gentamicin were discontinued. His therapy was changed and, over 2 weeks, the deposits predominately resolved. A 73-year-old man with kerato-uveitis received topical ofloxacin [dosage not stated], fusidic acid and cyclopentolate. Once the epithelial defect had resolved, he received dexamethasone. As the ulcer epithelialised he developed corneal ofloxacin deposits [time to reaction not stated]. Ofloxacin was discontinued and his therapy was changed. Over the following few weeks, the deposits resolved. A 89-year-old man with a corneal ulcer received intensive topical ofloxacin [dosage not stated] and cyclopentolate. Three days later, his corneal ulcer was healing but he developed corneal deposits. Ofloxacin was discontinued and his therapy was adjusted. The deposits resolved over the next few weeks. A 84-year-old woman received intensive ofloxacin [dosage not stated], cefuroxime, and subsequently gentamicin for a non-healing corneal ulcer. On day 5, corneal toxicity and corneal ofloxacin deposits were observed at the periphery of the epithelial defect. All topical drops were stopped for 24 hours. Moraxella was identified as the causative agent, which was sensitive to chloramphenicol. She underwent superficial keratectomy with corneal scraping and the ulcer was treated with preservative-free chloramphenicol and topical corticosteroids. The deposits resolved within a few weeks. A 82-year-old woman, who was receiving latanoprost for glaucoma, developed a corneal ulcer. She started receiving intensive topical ofloxacin [dosage not clearly stated] and cyclopentolate three times a day. By day 10, the corneal ulcer was healing but she developed corneal deposits. Ofloxacin was discontinued and the deposits rapidly resolved and the ulcer completely healed. A 83-year-old woman with a history of dendritic keratitis developed a corneal ulcer with hypopyon. She received ofloxacin drops [dose not stated] hourly and cyclopentolate. Corneal ofloxacin deposits were observed within 48 hours. Ofloxacin was replaced with gentamicin and cefuroxime. Her ulcer resolved, but her deposits persisted subepithelially. Author comment: "The avoidance of prolonged and intensive multiple topical therapy containing preservatives should promote ocular surface stability and help to reduce the incidence of precipitation of crystalline corneal deposits." Mitra A, et al. Corneal deposits and topical ofloxacin - the effect of polypharmacy in the management of microbial keratitis. Eye 21: 410-412, No. 3, Mar 2007 801071232 England
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