fortified cefazolin-gentamicin versus fortified vancomycin-ceftazidime drops for treatment of bacterial corneal ulcers

purpose: to compare the efficacy of treatment with fortified cefazolin-gentamicin versus fortified vancomycin-ceftazidime eye drops for treatment of bacterial corneal ulcers. methods: a double-blind clinical trial was performed on 89 patients with bacterial corneal ulcers who were referred to feiz hospital, isfahan, iran from 2004 to 2005. patients were randomly assigned to two groups: one group included 41 patients who received fortified cefazolin-gentamicin eye drops and the other group included 48 patients who received fortified vancomycin-ceftazidime eye drops. patients were evaluated in terms of time for re-epithelization, reduction of stromal infiltration and reduction in anterior chamber inflammation as well as culture results and drug complications. results: the patients included 57 (64%) male and 32 (36%) female subjects. cultures were negative in 46%. re-epithelization time was 13.2±3.1 days in the cefazolin-gentamicin group and 9.6±2.7 days in the vancomycin-ceftazidime group (p=0.01). time for reduction of stromal infiltration and corneal ulcer treatment was 17.7±4.3 days in the cefazolin-gentamicin group vs 13.8±3.6 days in the vancomycin-ceftazidime group (p=0.04). the most common complaint of patients was eye burning in 73.1% of cases in the cefazolin-gentamicin group and 62.9% of cases in the vancomycin-ceftazidime group (p=0.007). conclusion: fortified vancomycin-ceftazidime eye drops are more effective than fortified cefazolin-gentamicin eye drops for the treatment of bacterial corneal ulcers and seem to entail fewer adverse effects.