Peran Fluoroquinolone pada Pengobatan Ulkus Kornea karena Bakteri

Wahju Krisnoto/Wisnujono Soewono

Opthalmology Department

Faculty of Medicine Airlangga University / Dr. Soetomo Hospital Surabaya

The ideal ophthalmic anti-infective exhibits broad-spectrum activity against gram-positive, gram-negative, and atypical bacterial species. These pathogens can cause potentially blinding infections such as keratitis and corneal ulcer. These infections often require aggresive antibacterial therapy, prefeably with newer generation of antibiotics. Fluoroquinolones are bactericidal drugs, actively killing bacteria. A variety of microorganisms on the ocular surface continually provide a source for corneal ulcer. Bacterial corneal ulcerations are the most common form of corneal ulceration. In general, patients will present with decreased vision. Therapy for bacterial corneal ulceration has changed and evolved with the advent of the fluoroquinolones. These meds inhibit topoisomerase II, which is found primarily in gram(-) bacteria and topoisomerase IV, which predominates in gram(+) bacteria. Monotherapy with fluoroquinolone eye drops for the treatment of bacterial corneal ulcers led to shorter duration of intensive therapy and shorter hospital stay . This finding may have resulted from quicker clinical response of healing as a result of less toxicity found in the patients treated with fluoroquinolone. However, as some serious complications were encountered more commonly in the fluoroquinolone group, caution should be exercised in using fluoroquinolones in large, deep ulcers in the elderly.

Key words : fluoroquinolone, bacteria, corneal ulcer, toxicity