Can ocular antibiotics treatment prevent eye infection following a corneal abrasion? - Cochrane

What is the aim of this review?

This Cochrane Review aimed to find out whether ocular (given in the eye) antibiotics treatment can prevent eye infection following a corneal abrasion. We collected and analyzed all relevant studies to answer this question and found two studies.

Key messages

We could not find evidence that compared antibiotics with placebo (dummy treatment) or no treatment. We could not find enough evidence to support the use of one antibiotic over another to prevent eye infections with corneal abrasion.

What is a corneal abrasion?

The cornea is the transparent, protective outer layer of the eye. Corneal abrasion is a scratch of the cornea, usually caused by mechanical trauma, a foreign object in the eye, chemical burns, or contact lenses.

How is corneal abrasion managed?

Corneal abrasion causes pain and irritation, so treating physicians prescribe painkillers to help ease the pain. Some physicians may also prescribe antibiotics to prevent eye infections.

What did we want to find out?

We wanted to find out whether antibiotics could prevent eye infections following corneal abrasion.

What did we do?

We searched the medical literature for studies that tested antibiotics to prevent eye infection following a corneal abrasion.

What did we find?

We found two randomized controlled trials (studies where participants are randomly assigned to one of two or more treatment groups) with a total of 527 children and adults. One study in Denmark tested topical gels of chloramphenicol (a type of antibiotic) and fusidic acid (another type of antibiotic) (frequency was not clearly reported). The other study used a three-day course of ocular gel combinations of chloramphenicol (an antibiotic) and clotrimazole (an antifungal medication) or chloramphenicol and placebo (all three times daily) in India.

In the Danish study, the proportion of participants who recovered from corneal abrasion and had no infection was similar between groups. However, this study reported that one-third of participants in each treatment group experienced itching and discomfort of the eye.

The authors of the Indian study reported that 1% of participants experienced minor adverse events such as irritation and mild swelling of the eyelids and eye surface, and immunological reaction at the site.

We did not find any study that compared antibiotics with placebo or no treatment.

What does the evidence mean?

Due to a lack of robust evidence, we do not know whether the use of antibiotics can prevent eye infections in people with corneal abrasion or whether one antibiotic is better than another for this purpose.

How up-to-date is the evidence?

The evidence is current to 25 April 2021.