Antibióticos nas úlceras de córnea em animais. Você está fazendo a escolha certa?

Comentamos aqui sobre os principais fatores que devem ser levados em conta no momento de decidir qual antibiótico iremos empregar no tratamento das úlceras de córnea: 1) Penetração Tecidual; 2) Agregação à proteínas, lacrimais ou melanina; 3) MIC90/tempo; 4) Espectro de Ação vs Cultura e Antibiograma; 5) Epiteliotoxicidade. X) Não considero a administração de antibiótico sistêmico para úlceras de córnea, por considerar desnecessário se a afecção se restringe ao segmento anterior e superfície ocular. Bons antibióticos tópicos atingem essas regiões. Mas não tiramos essas informações do nada. Seguem os artigos que nos referenciamos. Pharmacokinetics of topically applied ciprofloxacin in tears of mesocephalic and brachycephalic dogs: https://pubmed.ncbi.nlm.nih.gov/18190... Antagonism between Bacteriostatic and Bactericidal Antibiotics Is Prevalent - https://www.ncbi.nlm.nih.gov/pmc/arti... Antimicrobial susceptibility and minimal inhibitory concentration of Pseudomonas aeruginosa isolated from septic ocular surface disease in different animal species: https://pubmed.ncbi.nlm.nih.gov/27928... Ciprofloxacin and ofloxacin aqueous humor concentrations after topical administration in dogs undergoing cataract surgery: https://pubmed.ncbi.nlm.nih.gov/15910... Penetration of topically applied ciprofloxacin and ofloxacin into the aqueous humor and vitreous: https://pubmed.ncbi.nlm.nih.gov/12663... Penetration of 0.3% ciprofloxacin, 0.3% ofloxacin, and 0.5% moxifloxacin into the cornea and aqueous humor of enucleated human eyes: https://www.scielo.br/j/bjmbr/a/yrkSZ... Evaluation of the bacterial ocular surface microbiome in ophthalmologically normal dogs prior to and following treatment with topical neomycin-polymyxin-bacitracin: https://journals.plos.org/plosone/art... Binding of drugs to eye melanin is not predictive of ocular toxicity: https://pubmed.ncbi.nlm.nih.gov/9927562/ Changes in the antibacterial activity of melanin-bound drugs: https://pubmed.ncbi.nlm.nih.gov/2111531/ Ocular Pharmacokinetic Effects of Drug Binding to Melanin Pigment and the Vitreous Humor: https://helda.helsinki.fi/bitstream/h... Implications of melanin binding in ocular drug delivery: https://pubmed.ncbi.nlm.nih.gov/29247... Intraocular penetration of gentamicin after once-daily aminoglycoside dosing: https://pubmed.ncbi.nlm.nih.gov/9730177/ Ocular penetration of topical antibiotics: study on the penetration of chloramphenicol, tobramycin and netilmicin into the anterior chamber after topical administration: https://onlinelibrary.wiley.com/doi/1...