December 9, 2022

Can ocular antibiotic treatment prevent ocular infection following corneal abrasion?

What is the purpose of this review?

This Cochrane Review aimed to find out if ocular antibiotic treatment (given into the eye) can prevent an eye infection following a corneal abrasion. We collected and analyzed all relevant studies to answer this question and found two studies.

Key messages

We found no evidence comparing antibiotics with placebo (a dummy treatment) or no treatment. We could not find enough evidence to support the use of one antibiotic over another to prevent eye infections with corneal abrasion.

What is a corneal abrasion?

The cornea is the transparent, protective outer layer of the eye. Corneal abrasion is a scratch on the cornea, usually caused by mechanical trauma, a foreign object in the eye, chemical burns, or contact lenses.

How is corneal abrasion managed?

Corneal abrasion causes pain and irritation, which is why treating physicians prescribe painkillers to help ease the pain. Some doctors may also prescribe antibiotics to prevent eye infections.

What did we want to find out?

We wanted to know if antibiotics could prevent eye infections following corneal abrasion.

What have we done?

We searched the medical literature for studies that tested antibiotics to prevent eye infection following corneal abrasion.

What did we find?

We found two randomized controlled trials (studies in which participants are randomly assigned to one of two or more treatment groups) with a total of 527 children and adults. A study in Denmark tested topical gels of chloramphenicol (a type of antibiotic) and fusidic acid (another type of antibiotic) (frequency not clearly stated). The other study used a three-day course of eye gel combinations of chloramphenicol (an antibiotic) and clotrimazole (an antifungal drug) or chloramphenicol and placebo (all three times a day) in India.

In the Danish study, the proportion of participants who recovered from a corneal abrasion and had no infection was similar between the groups. However, this study reported that one-third of participants in each treatment group experienced eye itching and discomfort.

The Indian study authors reported that 1% of participants experienced minor adverse effects such as irritation and mild swelling of the eyelids and eye surface, and immunological reaction at the site.

We found no studies comparing antibiotics with placebo or no treatment.

What does proof mean?

Due to a lack of strong evidence, we do not know if antibiotic use can prevent eye infections in people with corneal abrasion or if one antibiotic is better than another for this purpose.

How up-to-date is the evidence?

The evidence is current to April 25, 2021.