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Corticosteroids may not improve treatment of Nocardia keratitis
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Corticosteroids were not found to provide benefit in treating keratitis resulting from Nocardia species and yielded less favorable outcomes, a study found.
While patients with Nocardia ulcers demonstrated less improvement over the course of treatment than those with non-Nocardia bacterial keratitis, they started with better visual acuity and thus had less room for improvement, the study authors noted. Overall, Nocardia ulcers responded well to treatment.
The subgroup analysis of a multicenter controlled trial analyzed 500 patients with bacterial keratitis randomized to topical corticosteroid or placebo. All patients had received at least 48 hours of topical moxifloxacin.
The 55 patients with Nocardia corneal ulcer started with median Snellen visual acuity of 20/45, compared with 20/145 in the remaining patients. At 3 months, patients with and without Norcadia corneal ulcer had comparable visual acuity (20/25 vs. 20/40).
In patients with Nocardia ulcers, corticosteroids were associated with an average 0.4-mm increase in 3-month infiltrate or scar size (P = .03).
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