The Validity of Antibacterial Therapy in Chronic Keratitis and Herpes Virus Corneal Ulcers

Purpose: by microbiological study, to analyze the frequency of secondary bacterial infection in patients with primary and recurrent herpetic keratitis, taking into account antibiotic sensitivity.
Material and methods. A retrospective study of bacteriological analysis with antibiotic sensitivity testing was conducted at the S. Fyodorov Eye Microsurgery Federal State Institution. The study included 129 patients (129 eyes) with acute herpetic keratitis and 129 patients (129 eyes) with chronic herpetic keratitis. The sensitivity to gentamicin, levofloxacin, moxifloxacin, ciprofloxacin, chloramphenicol, and erythromycin was determined.
Results. Of the 129 patients with acute primary herpetic keratitis, 61.25 % had a secondary bacterial infection, with St. epidermidis being the most common (48.06 %). The highest resistance was observed for erythromycin (44.3 %), while the lowest resistance was observed for moxifloxacin (12.65 %). In patients with chronic recurrent infection, bacterial growth was detected in 56.58 % of cases (also with a predominance of St. epidermidis), and the resistance to all antibiotics was higher, particularly to erythromycin (50.68 %) and levofloxacin (39.72 %).
Conclusion. Prescription of initial antibacterial therapy in acute herpetic keratitis is due to the high risk of secondary infection. In case of recurrent course of the disease, given the variety of potential pathogens, it is advisable to perform a preliminary microbiological study to select an antibiotic based on sensitivity. The addition of bacterial flora significantly complicates the course of the herpetic process and worsens the prognosis for patient recovery.

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