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Evidence summaries

Topical Corticosteroids as Adjunctive Therapy for Bacterial Keratitis

There is insufficient evidence on the effectiveness of corticosteroid as an adjunctive treatment for bacterial keratitis. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 4 studies with a total of611 subjects (612 eyes). All trials reported data on visual acuity ranging from three weeks to one year, and none of them found any important difference between the corticosteroid group and the control group. The pilot study of the SCUT reported that time to re-epithelialization in the steroid group was 53% slower than the placebo group after adjusting for baseline epithelial defect size (hazard ratio (HR) 0.47; 95% confidence interval (CI) 0.23 to 0.94). However, the SCUT did not find any important difference in time to re-epithelialization (HR 0.92; 95% CI 0.76 to 1.11). For adverse events, none of the three small trials found any important difference between the two treatment groups. The investigators of the largest trial reported that more patients in the control group developed intraocular pressure (IOP) elevation (risk ratio (RR) 0.20; 95% CI 0.04 to 0.90). One trial reported quality of life and concluded that there was no difference between the two groups (data not available). We did not find any reports regarding economic outcomes.

    References

    • Herretes S, Wang X, Reyes JM. Topical corticosteroids as adjunctive therapy for bacterial keratitis. Cochrane Database Syst Rev 2014;(10):CD005430. [PubMed]

Primary/Secondary Keywords