Recommendations
| Dosage | Remarks | |
|---|---|---|
|
Combination therapy with 2 or 3 agents as eye drops: • chlorhexidine 0.02% - 0.06% • polyhexamethylene biguanide (PHMB) 0.02% • propamidine isethionate or hexamidine 0.1% |
Comments
- Eye-drop frequency and duration of treatment:
- days 1-2, instil hourly; day and night
- days 3-5, instil hourly during the daytime
- weeks 2-5, instil every 2 hours during the day.
- Thereafter instil 4 to 6 times daily for a period of 6 to 12 months.
- Availability of propamidine isethionate (Brolene) and polyhexamethylene biguanide (PHMB) in the Netherlands is limited. A physician's statement is required for use of propamidine isethionate.
- This form of keratitis requires intensive medical and surgical treatment.
- Use of the aminoglycoside antibiotics gentamicin and neomycin is discouraged because these agents induce cyst formation.
- Systemic treatment with imidazoles may achieve concentrations in the cornea that are too low to be effective.