Medication Burden for Patients With Bacterial Keratitis

Purpose: To understand medication use and patient burden for treatment of bacterial keratitis (BK).

Methods: A retrospective study was conducted examining medical records of adult patients with BK in an academic cornea practice. Data collected included medications used in the treatment of BK, dosing of medications, and the number and total duration of clinical encounters. Costs of medications were estimated using the average wholesale pharmacy price. Linear regression analysis was used to investigate associations of medication use with patient demographics and corneal culture results and reported with beta estimates (β) and 95% confidence intervals (95% CIs).

Results: Forty-eight patients with BK (56% female) were studied. Patients were treated for a median of 54 days with 10 visits, 5 unique medications, 587 drops, and 7 prescriptions. The estimated median medication cost was $933 (interquartile range: $457-$1422) US dollars. Positive bacterial growth was significantly associated with more visits (β: 6.16, 95% CI: 1.75-10.6, P = 0.007), more days of treatment (β: 86.8, 95% CI: 10.8-163, P = 0.026), more prescribed medications (β: 2.86, 95% CI: 1.04-4.67, P = 0.003), and more doses of medications (β: 796, 95% CI: 818-1412, P = 0.012) compared with patients who did not undergo corneal scraping. Patients were prescribed 132 more drops of medication for every 10 years of older age (β: 132, 95% CI: 18.2-246, P = 0.024). Sex and income were not associated with medication burden or treatment length.

Conclusions: Older patients and those with positive cultures incur the most medication burden in treatment of BK. Providers should be aware of medication usage and cost burden as it may affect compliance with treatment.