Increased tolerance to commonly used antibiotics in a porcine keratitis model.

. Bacterial keratitis, particularly caused by , is challenging to treat because of multi-drug tolerance, often associated with the formation of biofilms. Antibiotics in development are typically evaluated against planktonic bacteria in a culture medium, which may not accurately represent the complexity of infections . Developing a reliable, economic keratitis model that replicates some complexity of tissue infections could facilitate a deeper understanding of antibiotic efficacy, thus aiding in the optimization of treatment strategies for bacterial keratitis.. Here we investigated the efficacy of three commonly used antibiotics (gentamicin, ciprofloxacin and meropenem) against cytotoxic strain PA14 and invasive strain PA01 using an porcine keratitis model.. Both strains of were susceptible to the MIC of the three tested antibiotics. However, significantly higher concentrations were necessary to inhibit bacterial growth in the minimum biofilm eradication concentration (MBEC) assay, with both strains tolerating concentrations greater than 512 mg l of meropenem. When MIC and higher concentrations than MBEC (1024 mg l) of antibiotics were applied, ciprofloxacin exhibited the highest potency against both strains, followed by meropenem, while gentamicin showed the least potency. Despite this, none of the antibiotic concentrations used effectively cleared the infection, even after 18 h of continuous exposure. Further exploration of antibiotic concentrations and aligning dosing with clinical studies to validate the model is needed. Nonetheless, our porcine keratitis model could be a valuable tool for assessing antibiotic efficacy.