Les abcès de cornée : de la microbiologie à la thérapeutique

Abstract : Corneal abscess is a frequent and serious ophthalmologic disease. Therapeutics recommendations have been established since 20 years ago and are still used. However, some evolutions can be noticed such as the optimization of diagnostic method and the emergency of resistance because of massive antibiotics prescriptions. Because of these, an evolution in the microbiology of corneal abscess could appeared and change the indication of sample. That’s why the first study called « Differential microbiology of severe vs. non-severe infectious keratitis: a monocentric retrospective study of 92 consecutive cases » was done. Then, the identification of a pathogen allows a re-evaluation of antibiotic treatment thanks to the realization of an antibiogram. However, there is a mismatch between the antibiogram and the eye-drops antibiotic available in clinic. Furthermore, the notion of antibiotic sensitivity refers to a plasmatic concentration of antibiotic and cannot be used for corneal abscess. That’s why the second part of this work is related to a study called “Evaluation of eye-drops antibiotic concentration in corneal abscess”. This study is based on a mathematic model which evaluate pharmacological kinetic of eye-drops antibiotic. It aims to purpose an individual antibiotic administration based on personal germ sensibility and the study of antibiotic concentration on cornea.
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Thibaud Bouche. Les abcès de cornée : de la microbiologie à la thérapeutique. Médecine humaine et pathologie. 2018. ⟨dumas-02114499⟩

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