Deposits of topical norfloxacin in the treatment of bacterial keratitis. 1997

A Castillo, and J M Benitez del Castillo, and N Toledano, and D Diaz-Valle, and O Sayagues, and J Garcia-Sanchez
Hospital General de Móstoles, Madrid, Spain.

OBJECTIVE Fluoroquinolone solutions are widely used in therapy of bacterial keratitis. These drugs are safe, and their ocular side effects are mild and not serious in nature. The most frequent untoward effect associated with ciprofloxacin therapy has been a white crystalline deposit. This deposit has not been reported after using the other commercially available quinolones, ofloxacin and norfloxacin. METHODS We present three cases of norfloxacin deposits after treatment of bacterial keratitis. RESULTS In the three cases, the norfloxacin was substituted for another antibiotic effective against the bacteria, and the precipitate spontaneously resolved in all cases within a few days with no untoward ocular effect. CONCLUSIONS Crystalline corneal deposits can develop during topical norfloxacin therapy. The exact factors contributing to the formation are unknown, although the differences in the tear pH/solubility could be involved. Clinicians should be aware of this ocular side effect.

UI MeSH Term Description Entries
D007634 Keratitis Inflammation of the cornea. Keratitides
D008297 Male Males
D009643 Norfloxacin A synthetic fluoroquinolone (FLUOROQUINOLONES) with broad-spectrum antibacterial activity against most gram-negative and gram-positive bacteria. Norfloxacin inhibits bacterial DNA GYRASE. AM-0715,AM-715,MK-0366,MK-366,MK0366,MK366,Noroxin,AM 0715,AM 715,AM0715,MK 0366,MK 366
D009883 Ophthalmic Solutions Sterile solutions that are intended for instillation into the eye. It does not include solutions for cleaning eyeglasses or CONTACT LENS SOLUTIONS. Eye Drop,Eyedrop,Eyedrops,Ophthalmic Solution,Eye Drops,Drop, Eye,Drops, Eye,Solution, Ophthalmic,Solutions, Ophthalmic
D011232 Chemical Precipitation The formation of a solid in a solution as a result of a chemical reaction or the aggregation of soluble substances into complexes large enough to fall out of solution. Precipitation, Chemical
D003315 Cornea The transparent anterior portion of the fibrous coat of the eye consisting of five layers: stratified squamous CORNEAL EPITHELIUM; BOWMAN MEMBRANE; CORNEAL STROMA; DESCEMET MEMBRANE; and mesenchymal CORNEAL ENDOTHELIUM. It serves as the first refracting medium of the eye. It is structurally continuous with the SCLERA, avascular, receiving its nourishment by permeation through spaces between the lamellae, and is innervated by the ophthalmic division of the TRIGEMINAL NERVE via the ciliary nerves and those of the surrounding conjunctiva which together form plexuses. (Cline et al., Dictionary of Visual Science, 4th ed) Corneas
D003316 Corneal Diseases Diseases of the cornea. Corneal Disease,Disease, Corneal,Diseases, Corneal
D003460 Crystallization The formation of crystalline substances from solutions or melts. (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) Crystalline Polymorphs,Polymorphism, Crystallization,Crystal Growth,Polymorphic Crystals,Crystal, Polymorphic,Crystalline Polymorph,Crystallization Polymorphism,Crystallization Polymorphisms,Crystals, Polymorphic,Growth, Crystal,Polymorph, Crystalline,Polymorphic Crystal,Polymorphisms, Crystallization,Polymorphs, Crystalline
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

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