Evolution ? Sharma S, Kunimoto Research Proposal

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" (Sharma, Kunimoto, Garg, & Rao) They believe that he information they are providing will allow the clinician to have a more expansive approach in treating bacterial keratitis and in deciding which secondary antibiotic to use.

The goal of initial antibiotic therapy for bacterial keratitis is the proper selection of a drug which has coverage for the aetiopathogen. Microscopic evaluation of corneal smears can provide insight into the identity of the pathogen, but when smear examination is uninformative the principle of managing bacterial keratitis has been to use antibiotics which have coverage that is sufficiently broad and effective to treat the leading corneal pathogens. (Sharma, Kunimoto, Garg, & Rao)

The main thrust for their interest in this study was to assist the clinician who is in less that ideal setting when faced with treating bacterial keratitis. As mentioned previously the virulent nature of this disease necessitates immediate treatment but the proper facilities are not always present for the clinician to extract corneal scrapings for analysis.

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Therefore they have provided information that will help this clinician to use secondary antibiotic with a certain degree of judgment when initial antibiotic treatment is unsuccessful. This should provide assistance in all areas of treatment for this disease. Furthermore, by increasing the information available regarding success rate of various antibiotic therapies, the authors hope to reduce the time necessary in stopping the further deterioration of the patient's eyesight.

The authors note that one of the obvious limitation of their study is that all the data was gathered from the Hyderabad, India region and that strain of bacteria vary from region to region and some may develop more resistance to specific antibiotic than other, as is their nature to do so. They also do not promote the diagnosis of bacterial keratitis without the proper laboratory test to discover the specific strain when beginning treat and advise against using broad spectrum antibiotics as this further exacerbates the problem of resistance to more and more antibiotic therapies.

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