Hochdosierte antibiotische Kombinationsbehandlung bei schweren therapierefraktären Uveitiden und nekrotisierenden (Chorio-) Retinitiden

Abstract

Twelve patients with extremely severe uveitis and two patients with necrotizing (chorio-)retinitis were treated with a combination of antibiotics consisting of penicillin G, gentamicin and metronidazole. The antibiotics were administered in 5 cases (all uveitis patients) after unsuccessful long-term treatment with other drugs, in nine cases after short-term treatment with other drugs or immediately. The treatment was effective in 10 of the uveitis patients, including all 5 cases in which the previous treatment had been unsuccessful. In 2 cases it was ineffective. It was effective, however, in both of the cases of necrotizing (chorio-)retinitis. The duration of the required treatment with antibiotics was not significantly prolonged in cases which had previously undergone long-term treatment with other drugs. However, the clinically detectable onset of improvement of vision and of the findings was significantly delayed. Despite some cogent connections between the antibiotics therapy and the improvement in the clinical picture, no well-founded conclusions as to etiology can be derived for the uveitis or necrotizing (chorio-)retinitis patients in question. The successful treatment of problematic cases identifies therapy with antibiotics as a therapeutic alternative.