Outcomes of Pythium keratitis: a meta-analysis of individual patient data.
Pythium
azithromycin
corneal ulcer
linezolid
penetrating keratoplasty
pythiosis
systematic review
Journal
Current ophthalmology reports
ISSN: 2167-4868
Titre abrégé: Curr Ophthalmol Rep
Pays: United States
ID NLM: 101605578
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
medline:
30
5
2023
pubmed:
30
5
2023
entrez:
30
5
2023
Statut:
ppublish
Résumé
Pythium keratitis is a difficult-to-treat corneal infection. A meta-analysis of individual patient data from observational studies of Pythium keratitis was performed. The outcomes of interest were therapeutic penetrating keratoplasty (TPK) and globe removal (evisceration, enucleation, or exenteration); the main exposures were linezolid and azithromycin use. Of 46 eligible articles, individual patient data were available for 306 eyes (34 studies). Pythium keratitis was associated with high rates of TPK (80%, 95%CI 70-87%) and globe removal (25%, 95%CI 13-43). In multivariable models adjusting for age and country, fewer TPKs were performed in patients treated with azithromycin (RR=0.80, 95%CI 0.67-0.96; Studies of Pythium keratitis reported high rates of TPK and globe removal. Use of azithromycin and linezolid was associated with a lower rate of TPK. While promising, these results should be interpreted with caution given the biases inherent to observational studies.
Sections du résumé
Background
UNASSIGNED
Pythium keratitis is a difficult-to-treat corneal infection.
Methods
UNASSIGNED
A meta-analysis of individual patient data from observational studies of Pythium keratitis was performed. The outcomes of interest were therapeutic penetrating keratoplasty (TPK) and globe removal (evisceration, enucleation, or exenteration); the main exposures were linezolid and azithromycin use.
Findings
UNASSIGNED
Of 46 eligible articles, individual patient data were available for 306 eyes (34 studies). Pythium keratitis was associated with high rates of TPK (80%, 95%CI 70-87%) and globe removal (25%, 95%CI 13-43). In multivariable models adjusting for age and country, fewer TPKs were performed in patients treated with azithromycin (RR=0.80, 95%CI 0.67-0.96;
Conclusions
UNASSIGNED
Studies of Pythium keratitis reported high rates of TPK and globe removal. Use of azithromycin and linezolid was associated with a lower rate of TPK. While promising, these results should be interpreted with caution given the biases inherent to observational studies.
Identifiants
pubmed: 37250102
doi: 10.1007/s40135-022-00302-7
pmc: PMC10211475
mid: NIHMS1885696
doi:
Types de publication
Journal Article
Langues
eng
Pagination
198-208Subventions
Organisme : FIC NIH HHS
ID : D43 TW009343
Pays : United States
Déclaration de conflit d'intérêts
Conflict of interest: No conflicting relationship exists for any author.
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