Chlorhexidine as an effective agent against Chlamydia trachomatis in vitro and in vivo

Nisbet, Ian T.; Graham, Doris M.; Spicer, Paul E.; Tibbs, G J

doi:10.1128/aac.16.6.855

Cited by 10 publications

(3 citation statements)

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“…Chlorhexidine is well known to be effective against a range of Gram positive and Gram negative bacteria, is being used for the treatment of Acanthamoeba keratitis,10 11 and was also thought from one study to be effective against Chlamydia trachomatis. 12 Chlorhexidine digluconate is already used as a preservative in eye preparations and is therefore approved for use in low concentrations in the human eye. It has been used in several other clinical situations for about 40 years.…”

Section: Discussionmentioning

confidence: 99%

Randomised trial of 0.2% chlorhexidine gluconate and 2.5% natamycin for fungal keratitis in Bangladesh

Rahman¹,

Johnson

Husain³

et al. 1998

British Journal of Ophthalmology

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Aim-The management of suppurative keratitis due to filamentous fungi presents severe problems in tropical countries. The aim was to demonstrate the eYcacy of chlorhexidine 0.2% drops as an inexpensive antimicrobial agent, which could be widely distributed for fungal keratitis. Methods-Successive patients presenting to the Chittagong Eye Institute and Training Complex with corneal ulcers were admitted to the trial when fungal hyphae had been seen on microscopy. They were randomised to drop treatment with chlorhexidine gluconate 0.2% or the standard local treatment natamycin 2.5%. The diameters, depths, and other features of the ulcers were measured and photographed at regular intervals. The outcome measures were healing at 21 days and presence or absence of toxicity. If there was not a favourable response at 5 days, "treatment failure" was recorded and the treatment was changed to one or more of three options, which included econazole 1% in the latter part of the trial. Results-71 patients were recruited to the trial, of which 35 were randomised to chlorhexidine and 36 to natamycin. One allocated to natamycin grew bacteria and therefore was excluded from the analysis. None of the severe ulcers was fully healed at 21 days of treatment, but three of those allocated to chlorhexidine eventually healed in times up to 60 days. Of the nonsevere ulcers, 66.7% were healed at 21 days with chlorhexidine and 36.0% with natamycin, a relative eYcacy (RE) of 1.85 (CL 1.01-3.39, p = 0.04). If those ulcers were excluded where fungi were seen in the scraping but did not grow on culture, the estimated eYcacy ratio does not change but becomes less precise because of smaller numbers. Equal numbers of Aspergillus ( Ophthalmologists working in a humid tropical environment are aware of how serious the problems of corneal ulcers caused by fungi can be. Often the onset follows a minor injury to the cornea in an agricultural worker, progresses slowly, and may be treated with traditional remedies before the suVerer presents with an advanced ulcer at an eye clinic. A prolonged period of pain and time unable to work follows, which subsistence farmers can often not aVord, ending in perforation of the cornea and evisceration or enucleation of the eye. The ophthalmologist frequently has no access to a microbiology laboratory, and specific antifungal drugs for the eye are not available.The proportion of suppurative keratitis due to filamentous fungi is sometimes underestimated. In reports from Bangladesh this proportion has varied from 23% 1 to 33%, 2 36%, 3 and 40%. 4 In southern Florida, fungi accounted for 35% of isolates.5 In Accra, Ghana, it was found that fungi alone were responsible for 49% of positive cultures, and if mixed fungal and bacterial infections were included, fungi occurred in 56% of cultures.6 A wide range of species of fungi have been isolated. The commonest genera are Aspergillus and Fusarium. The subject of mycotic keratitis has been thoroughly reviewed by Thomas. 7 In a search for stable, inexpensive antimicro...

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Section: Discussionmentioning

confidence: 99%

Randomised trial of 0.2% chlorhexidine gluconate and 2.5% natamycin for fungal keratitis in Bangladesh

Rahman¹,

Johnson

Husain³

et al. 1998

British Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…In the mid‐1970s, longitudinal studies on the prevalence and treatment of trachoma were conducted in a group of communities in the Katherine region by a team lead by one of us (PS) (as a District Medical Officer in the Northern Territory. [The team included members from the University of Melbourne (DG) and the Royal Victorian Eye and Ear Hospital] 7 . Further studies on trachoma were conducted in one of the same communities in 2007 8 …”

Section: Introductionmentioning

confidence: 99%

“…[The team included members from the University of Melbourne (DG) and the Royal Victorian Eye and Ear Hospital]. 7 Further studies on trachoma were conducted in one of the same communities in 2007. 8 We were able to obtain baseline images of the everted upper eyelids obtained during these two studies, and this paper presents the prevalence and severity of active trachoma in children in this community at those two time points.…”

Section: Introductionmentioning

confidence: 99%