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Br J Ophthalmol 82:137-145 doi:10.1136/bjo.82.2.137
  • Original Article
    • Clinical science

Antimicrobial management of presumed microbial keratitis: guidelines for treatment of central and peripheral ulcers

Table 3

First and second line broad spectrum therapy

First line:
Suspected pathogen:
 Bacteria Gentamicin 1.5% + cefuroxime 5%a,b or ciprofloxacin or ofloxacin 0.3% as monotherapy 36 37
 Fungi Amphotericin 0.1% or natamycin 5%
 Amoebae Chlorhexidine 0.02% + propamidine 0.1%
Second line:
Suspected pathogen:
 Fastidious bacteria Amikacin 2.5% + vancomycin 5% + Polytrim or ciprofloxacin 0.3%
 Fungi Amphotericin 0.1% or natamycin 5%
 Amoebae Chlorhexidine 0.02% + propamidine 0.1%

  • S pneumoniae, use penicillin 0.3% instead.

  • Ps aeruginosa, add ticarcillin 5% or ceftazidime 5% or ciprofloxacin 0.3%.

  • ↵Ciprofloxacin 0.3% and ofloxacin 0.3% are commercially available in UK.

  • ↵Natamycin is not commercially available in UK.

  • Withhold steroids unless already in use before presentation.

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