Bacterial infections are by far the most frequent cause of infectious keratitis in high-income countries. The clinical appearance can vary widely depending on the type and species of bacteria, ranging from small superficial infiltrates to necrotizing forms. The numerous classes of available antibiotics render the treatment scope diverse and complex, especially before the pathogen has been specified and the sensitivity to antibiotics has been tested. New therapeutic approaches to reduce bacterial virulence are in development. This CME article focuses on the clinical, diagnostic and therapeutic approaches to recognize and treat bacterial keratitis.