Intrastromal Moxifloxacin as an Adjunctive Therapy in Recalcitrant Bacterial Keratitis

Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Bacterial keratitis is a potentially sight-threatening corneal infection that is commonly treated with intensive topical antibiotics. Despite appropriate therapy, some cases show inadequate clinical response, particularly when the infection involves the deep corneal stroma. Limited penetration of topical antibiotics into deeper corneal layers may contribute to treatment failure in these recalcitrant cases. Intrastromal antibiotic injection is a targeted drug-delivery approach that allows high local antimicrobial concentrations directly at the site of infection. Moxifloxacin is a broad-spectrum fluoroquinolone with proven efficacy in bacterial keratitis and favorable corneal tissue penetration. However, evidence regarding the clinical benefit and safety of intrastromal moxifloxacin as an adjunctive treatment remains limited. This randomized controlled trial aims to evaluate the efficacy and safety of intrastromal moxifloxacin injection as an adjunct to standard topical moxifloxacin therapy compared with topical therapy alone in patients with recalcitrant bacterial keratitis. The primary outcome is time to complete clinical resolution of infection. Secondary outcomes include visual acuity improvement, ulcer healing rate, need for additional interventions, and treatment-related complications.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 20
Healthy Volunteers: f
View:

• • Age ≥ 18 years

‣ Clinical diagnosis of bacterial keratitis confirmed by corneal scraping and microbiology

⁃ Recalcitrant keratitis defined as no significant clinical improvement after 48-72 hours of intensive topical antibiotic therapy

⁃ Ability to provide written informed consent

Locations
Other Locations
Egypt
Mahmoud Ramadan Amer
RECRUITING
Minya
Contact Information
Primary
Mahmoud Ramadan Amer, MD
mahmoud3mer89@gmail.com
0201068005575
Time Frame
Start Date: 2025-10-01
Estimated Completion Date: 2026-04-01
Participants
Target number of participants: 60
Treatments
Experimental: Intrastromal moxifloxacin injection plus standard topical moxifloxacin therapy
Intrastromal injection of preservative-free moxifloxacin 0.5% using a 30-gauge needle under aseptic conditions.
Experimental: Standard topical moxifloxacin therapy alone
• Intensive topical moxifloxacin eye drops every 1-2 hours initially, tapered according to standard clinical protocol and response
Related Therapeutic Areas
Sponsors
Leads: Minia University

This content was sourced from clinicaltrials.gov