Use of topical meropenem in management of hospital acquired Pseudomonas ocular infections

We report a case series of four eyes of four patients where resistant strains of Pseudomonasaeruginosa in nosocomial ocular infections were treated with topical meropenem with a successful outcome. Pseudomonas infections are known to be very fulminant. We observed strains of P. aeruginosa in four eyes resistant to all routine drugs such as fluoroquinolones, aminoglycosides and cephalosporins. Three eyes presented with infective corneal ulcers and one eye had endophthalmitis. Culture sensitivity of corneal scrape and aqueous tap respectively of each patient showed P. aeruginosa (Gram-negative bacilli) sensitive to carbapenem (meropenem and imipenem) group of drugs. These patients were treated with a topical meropenem 50 mg/ml once in an hour and responded dramaticaly and we could salvage all eyes. Topical meropenem 50 mg/ml, which is not routinely used in ocular infections is thus an effective drug for management of hospital acquired resistant Pseudomonas ocular infections.