Herpes simplex keratitis (HSK) local treatment guideline audit 2018-2019

BackgroundThe aim of this paper is to report the adherence of clinician prescription to the evidence-based herpes simplex keratitis (HSK) guideline at the Sydney Eye Hospital, Australia, in order to assess the sustainability of guideline implementation.MethodsA retrospective review was conducted of patients, aged 18 years and above, receiving anti-viral treatment for HSK at the Sydney Eye Hospital from 1 January 2018 to 31 December 2019. Patients were identified from pharmacy records, viral swab results, and hospital coding data.ResultsThree hundred and thirty-six eyes of 335 patients, median age 58 years (range 18-103); 61% males were included. Anti-viral therapy was given for therapeutic and prophylactic indications at presentation in 287 (86%) and 48 (14%) patients, respectively.The dose of prescribed antivirals was in alignment with the guidelines in 69% (231/335) of eyes compared to 75% (64/85) in 2017 (P = 0.254) in our prior study. For the type of HSK, alignment with the guidelines was found in 80/112 eyes (71%) with epithelial, 43/68 (63%) with stromal, 13/17 (76%) with endothelial, 52/90 (58%) with keratouveitis, and 43/48 (90%) on prophylaxis.ConclusionsClinicians were similarly adherent to a HSK treatment guideline 2 years after its implementation. Regular activities are needed to sustain knowledge.