Successful Salvage Treatment of Scedosporium apiospermum Keratitis with Topical Voriconazole After Failure of Natamycin

Al‐Badriyeh, Daoud; Leung, Lok; Davies, Geoff; Stewart, Kay; Kong, David Chee Ming

doi:10.1345/aph.1m008

Cited by 18 publications

(22 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The drug is also shown to be effective in invasive or serious fungal infections as well as serious infections refractory to other antifungal agents and thus has been approved by the U.S. Food and Drug Administration and European Medicines Agency for the treatment of invasive aspergillosis and serious infections caused by Fusarium species and Scedosporium apiospermum that are refractory to other antifungal agents (28). The use of voriconazole in treating ocular infections, such as fungal keratitis or endophthalmitis, is increasing, and several researchers have reported good efficacy even in recalcitrant ocular fungal infections (1,4,18,21,24,27,28). The drug is currently in widespread use and is administered systemically and/or topically (1,24,31,32).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Cytotoxicity of Voriconazole on Cultured Human Corneal Endothelial Cells

Han

Shin

Hyon

et al. 2011

Antimicrob Agents Chemother

View full text Add to dashboard Cite

The purpose of the present study was to evaluate the toxicity of voriconazole on cultured human corneal endothelial cells (HCECs). HCECs were cultured and exposed to various concentrations of voriconazole (5.0 to 1,000 g/ml). Cell viability was measured using a Cell Counting Kit-8 (CCK-8) and live/dead viability/ cytotoxicity assays. Cell damage was assessed using phase-contrast microscopy after 24

show abstract

mentioning

confidence: 99%

“…The use of voriconazole in treating ocular infections, such as fungal keratitis or endophthalmitis, is increasing, and several researchers have reported good efficacy even in recalcitrant ocular fungal infections (1,4,18,21,24,27,28). The drug is currently in widespread use and is administered systemically and/or topically (1,24,31,32).…”

mentioning

confidence: 99%

Cytotoxicity of Voriconazole on Cultured Human Corneal Endothelial Cells

Han

Shin

Hyon

et al. 2011

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…Voriconazole has excellent in vitro activity against Candida and Aspergillus species is known to be resistant to amphotericin B, fluconazole, and itraconazole [18]. Voriconazole has been used successfully to treat fungal keratitis either as a standalone topical therapy [9, 10] or with systemic administration [7]. Although voriconazole is the drug of choice in recalcitrant resistant fungal keratitis, there have been also reported cases that were resistant to voriconazole.…”

Section: Discussionmentioning

confidence: 99%

“…Voriconazole, fluconazole, amphotericin B, and natamycin are the conventional antifungal agents, which are well known options announced to be successful in fungal keratitis in many studies [8–10]. But fungal keratitis resistant to these drugs had been also reported in literature [11, 12].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Posaconazole in Recalcitrant Fungal Keratitis Resistant to Conventional Antifungal Drugs

Altun

Kurna

Şengör

et al. 2014

Case Reports in Ophthalmological Medicine

View full text Add to dashboard Cite

Purpose. To present the success of posaconazole in two cases with recalcitrant fugal keratitis that were resistant to conventional antifungal drugs. Method. We presented two cases that were treated with posaconazole after the failure of fluconazole or voriconazole, amphotericin B, and natamycin therapy. Case 1 was a 62-year-old man with a history of ocular trauma. He had been using topical fluorometholone and tobramycin. His best corrected visual acuity (BCVA) was hand motion. He had 5.0 × 4.5 mm area of deep corneal ulcer with stromal infiltration. Case 2 was a 14-year-old contact lens user. He had been using topical moxifloxacin, tobramycin, and cyclopentolate. His BCVA was 20/200. He had a 4.0 × 3.0 mm area of pericentral corneal ulcer with deep corneal stromal infiltration and 2 mm hypopyon. Results. Both patients initially received systemic and topical fluconazole or voriconazole and amphotericin B and topical natamycin that were all ineffective. But the response of posaconazole was significant. After posaconazole, progressive improvement was seen in clinical appearance. BCVA improved to 20/100 in case 1 and 20/40 in case 2. Conclusion. Posaconazole might be an effective treatment option for recalcitrant fusarium keratitis and/or endophthalmitis resistant to conventional antifungal drugs.

show abstract

“…19 In the two case reports by Al-Badriyeh et al, topical 1% voriconazole eye drops were used as a standalone therapy to treat S. apiospermum keratitis and C. albicans keratitis which were unresponsive for empirical treatment. 20,21 In these case reports, voriconazole eye drops were typically administered with a dosing frequency of one drop every 0.5, 1.0, or 2.0 hours for duration of one month. Increasing the concentration of voriconazole eye drops may lead to increased efficacy and/or reduced dosing frequency; however, the benefit of using concentrations greater than 1% has not been evaluated in patients with fungal keratitis .…”

Section: A Topical Eye Dropsmentioning

confidence: 99%