Doxycycline in the management of pseudomonas corneal melting: two case reports and a review of the literature

Eye Contact Lens. 2003 Oct;29(4):258-61. doi: 10.1097/01.icl.0000086490.38331.58.


Background: Pseudomonas keratitis can result in the breakdown of collagen with subsequent corneal melting and perforation. The use of antimetalloproteinases may help to stabilize melting and prevent imminent perforation of the cornea. The use of topical protease inhibitors and neutrophil inhibitors is of limited value. Tetracyclines, however, have been shown to have anticollagenolytic activity and inhibit metalloproteinases, and they may suppress connective tissue breakdown.

Purpose: To establish the stabilization of corneal melting in cases of Pseudomonas keratitis.

Methods: Two young patients with severe contact lens-associated Pseudomonas keratitis and corneal melting were treated with oral doxycycline and standard topical treatment.

Results: Corneal melting was stabilized in each patient, and perforation was avoided.

Conclusions: Tetracyclines have an anticollagenolytic action in addition to their antimicrobial activity. The use of doxycycline as an adjunctive therapy in the management of Pseudomonas corneal melting may help to stabilize corneal breakdown and prevent subsequent perforation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Administration, Oral
  • Administration, Topical
  • Adolescent
  • Adult
  • Collagen / metabolism
  • Contact Lenses, Hydrophilic / adverse effects
  • Cornea / drug effects*
  • Cornea / metabolism
  • Corneal Ulcer / drug therapy*
  • Corneal Ulcer / microbiology*
  • Doxycycline / therapeutic use*
  • Drug Therapy, Combination / therapeutic use
  • Eye Infections, Bacterial / drug therapy*
  • Eye Infections, Bacterial / microbiology
  • Female
  • Humans
  • Male
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / microbiology


  • Collagen
  • Doxycycline