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

ABSTRACT Background The 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. Methods A 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. Results Three 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. Conclusions Clinicians were similarly adherent to a HSK treatment guideline 2 years after its implementation. Regular activities are needed to sustain knowledge.