In dogs with uncomplicated corneal ulcers, do antibacterial eye drops reduce the risk of infection?

¹University of Minnesota College of Veterinary Medicine, 1365 Gortner Ave, St Paul, MN 55108, USA
^*Corresponding Author (joh10898@umn.edu)

PICO question

In dogs with uncomplicated corneal ulcers does treatment with prophylactic antibacterial eye drops reduce the risk of secondary infection when compared to no treatment with prophylactic antibacterial eye drops?

Clinical bottom line

Category of research question

Treatment

The number and type of study designs reviewed

Zero

Strength of evidence

Zero

Outcomes reported

None

Conclusion

There were no published papers found to address the PICO

How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

You are presented with a 4 year old, female spayed dog of mixed breed with an acute onset of epiphora and blepharospasm of the right eye. Ocular exam and fluorescein staining reveal a superficial corneal ulcer, which has not received any treatment prior to diagnosis. The dog’s owner has already spent more money than she would like just for the exam and wants to know whether the recommended antibacterial drops are necessary.

There was no peer-reviewed evidence that met the inclusion criteria to summarise.

In dogs with uncomplicated corneal ulcers, the administration of prophylactic topical ophthalmic antibacterials is well documented and recommended in textbooks on veterinary ophthalmology as the standard of care (Maggs et al., 2018); for the purpose of this Knowledge Summary, an uncomplicated corneal ulcer was defined as a new onset superficial corneal ulcer. Despite this recommendation, there have been no studies to demonstrate a significant difference in infection rates in affected dogs receiving prophylactic topical ophthalmic antibacterials compared to dogs that do not. However, the potential negative impacts of not treating uncomplicated corneal ulcers with topical ophthalmic antibacterials could be significant, possibly resulting in secondary ocular infections, melting deep corneal ulcers, and may eventually lead to loss of vision or loss of the eye. Therefore, unless robust evidence is established to refute the current dogma, it is recommended that practitioners continue to uphold the current standard of care.

Search Strategy
Databases searched and dates covered:	PubMed on NCBI Platform; 1950–2020 CAB Abstracts on OVID Platform; 1973–2020
Search strategy:	CAB Abstracts and PubMed: ((dogs) AND (((corneal ulcer) OR (keratitis)) OR (corneal abrasion))) AND ((((treatment) OR (therapy)) OR (ophthalmic solutions)) OR (antibiotic))
Dates searches performed:	07 Dec 2020

Exclusion / Inclusion Criteria
Exclusion:	Articles not available in English, clinical review articles, book chapters, articles not available for review
Inclusion:	Articles relevant to the PICO (involving uncomplicated corneal ulcers that were treated to resolution)

Search Outcome
Database	Number of results	Excluded – Did not address the PICO	Excluded – Not English language	Excluded – Non-canine	Total relevant papers
CAB Abstracts	331	223	97	11	0
PubMed	391	335	33	23	0
Total relevant papers when duplicates removed					0

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Disclaimer

Knowledge Summaries are a peer-reviewed article type which aims to answer a clinical question based on the best available current evidence. It does not override the responsibility of the practitioner. Informed decisions should be made by considering such factors as individual clinical expertise and judgement along with patient’s circumstances and owners’ values. Knowledge Summaries are a resource to help inform and any opinions expressed within the Knowledge Summaries are the author's own and do not necessarily reflect the view of the RCVS Knowledge. Authors are responsible for the accuracy of the content. While the Editor and Publisher believe that all content herein are in accord with current recommendations and practice at the time of publication, they accept no legal responsibility for any errors or omissions, and make no warranty, express or implied, with respect to material contained within. For further information please refer to our Terms of Use.