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. 2023 Jul;261(7):1961-1969.
doi: 10.1007/s00417-023-06003-6. Epub 2023 Feb 23.

Practice patterns in the management of bacterial keratitis: a five-continent survey

Simon Wespiser  1 , Emilia Koestel  2 , Thibaut Fabacher  3 , Arnaud Sauer  1 ; SMIK study group; Tristan Bourcier  1   4
Collaborators, Affiliations

Practice patterns in the management of bacterial keratitis: a five-continent survey

Simon Wespiser et al. Graefes Arch Clin Exp Ophthalmol. 2023 Jul.

Abstract

Purpose: To assess the current diagnostic and therapeutic practice patterns in early management of bacterial keratitis over five continents.

Methods: Between March and August 2019, we distributed an online survey including two clinical scenarios of bacterial keratitis, namely, a mild case and severe case, to 2936 ophthalmologists from 144 countries around the world. The survey consisted of 29 questions. We performed descriptive statistics and a comparative analysis of the answers according to the participants' continent of practice, practice setting, seniority, and subspecialty.

Results: We received 237 surveys from 54 countries (8% response rate). The proportion of respondents performing microbiological investigations was higher in North America, Asia, Europe, and Oceania than Africa and South America (p < 0.05). This ratio was also higher among ocular surface specialists than for other ophthalmologists (p < 0.001). For mild cases, fluoroquinolone monotherapy and a combination of two or more antibiotics were prescribed by 46% and 41% respondents, respectively. For severe cases, fluoroquinolone monotherapy and a combination of antibiotics were prescribed by 20% and 78% respondents, respectively. Fluoroquinolone monotherapy was the most commonly prescribed treatment in South America, Africa, and Oceania. A combination of two antibiotics was preferentially prescribed in the rest of the world. Topical steroids were prescribed in both circumstances, respectively, in 72% and 75% of cases.

Conclusion: Our results highlight essential geographical disparities in the current management of bacterial keratitis over five continents.

Keywords: Antibiotics; Bacterial keratitis; Diagnosis; Survey; Treatment.

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