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Journal of Ophthalmology
Volume 2009 (2009), Article ID 794935, 3 pages
http://dx.doi.org/10.1155/2009/794935
Case Report

Severe Keratitis Caused by Pseudomonas aeruginosa Successfully Treated with Ceftazidime Associated with Acetazolamide

1Department of Pharmacy, Pharmacology, and Toxicology, Hotel-Dieu, 1 Place Notre-Dame, 75004 Paris, France
2Department of Ophthalmology, Hotel-Dieu, 1 Place Notre-Dame, 75004 Paris, France

Received 18 February 2009; Accepted 2 April 2009

Academic Editor: David Wilkie

Copyright © 2009 Benoit Hue et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. To report a case of microbial keratitis caused by Pseudomonas aeruginosa treated with a combination of acetazolamide and ceftazidime. Methods. Case report. Results. We report the case of a 17-year-old contact lens-wearing female who developed severe keratitis due to Pseudomonas aeruginosa temporarily healed with topical fortified antibiotic eye drops. After few days, the patient relapsed, and topical and intravenous ceftazidime were added. Concomitantly, oral administration of acetazolamide was prescribed. This carbonic anhydrase inhibitor was added to the antibiotic regimen in order to decrease the anterior chamber pH, and then, the ceftazidime ionization. By lowering the state of ionization of the antibiotic in the aqueous humor, its concentration was increased. This was confirmed by an improvement of the patient within few days and a rapid eradication of the infection. Conclusion. This is the first reported case of keratitis caused by P. aeruginosa successfully treated using acetazolamide as an enhancer of ceftazidime effectiveness.