Voriconazole <i>versus</i> natamycin as primary treatment in fungal corneal ulcers

Arora, Ritu; Gupta, Deepa; Goyal, Jawahar Lal; Kaur, Ravinder

doi:10.1111/j.1442-9071.2010.02473.x

Cited by 61 publications

(54 citation statements)

References 29 publications

(29 reference statements)

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“…[21][22][23][24][25][26] The relatively common failure of medical therapy is attributed to both poor penetration and variable efficacy of available antifungal medications. [27][28][29][30][31] Therapeutic keratoplasty (TKP) is often required for medically uncontrolled fungal keratitis with or without corneal perforation. [32][33][34][35][36][37][38][39][40][41][42] Although there is a guarded prognosis for the maintenance of graft clarity, [32][33][34][35][36][37][38][39][40][41][42][43][44] subsequent visual rehabilitation with optical keratoplasty (OKP) procedures, [32][33][34][35][36][37][38][39][40][41][42][43][44]…”

mentioning

confidence: 99%

Outcomes of Treatment of Fungal Keratitis at the University of Iowa Hospitals and Clinics

Rogers

Goins

Sutphin

et al. 2013

Cornea

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mentioning

confidence: 99%

Outcomes of Treatment of Fungal Keratitis at the University of Iowa Hospitals and Clinics

Rogers

Goins

Sutphin

et al. 2013

Cornea

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“…In vitro studies suggest that susceptibility is drug/species specific. Voriconazole had the broadest spectrum in general, but natamycin had the lowest and better susceptibility for Fusarium species [92,96,97].…”

Section: Azolesmentioning

confidence: 99%

Pharmacological treatment for infectious corneal ulcers

Miller¹

2013

Expert Opinion on Pharmacotherapy

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Topical application with a broad-spectrum antimicrobial remains the preferred method for the pharmacological management of infectious corneal ulcers. Increasing reports of clinical failures and in vitro resistance to antibiotics to treat the most common infectious (bacterial) corneal ulcers are increasing concerns. New approaches for improvement in the pharmacological management of corneal ulcers should focus on strategies for a more rational and evidence-based use of current antimicrobials and development of products to modulate the host immune response and to neutralize microbial toxins and other immune modulators.

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“…Bunya et al [9] reported that voriconazole has been successful when amphotericin B or fluconazole have been unsuccessful in cases of drug-resistant fungal keratitis and endophthalmitis. Arora et al [10] evaluated the efficacy of topical 1% voriconazole versus 5% natamycin in treatment of 30 patients with fungal corneal ulcers. They concluded that topical 1% voriconazole was a safe and effective drug in primary management of fungal keratitis.…”

Section: Discussionmentioning

confidence: 99%

Topical Voriconazole Drops With and Without Intrastromal Voriconazole Injection for Treatment of Deep or Resistant Fungal Keratitis

Solaiman¹,

Alkawas²,

Ibrahim³

2015

J Clin Exp Ophthalmol

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Purpose: To compare the safety and efficacy of topical voriconazole drops with and without intrastromal voriconazole injection for treatment of deep and/or resistant fungal keratitis. Patients and methods:A prospective, randomized and comparative study performed on eyes with deep and/or resistant fungal keratitis. Eyes were randomly allocated into two groups according to their order of presentation. Group (A) included eyes treated with intrastromal injection(s) of voriconazole (50 μg/0.1 ml) plus voriconazole eye drops 1% and group (B) included eyes treated with topical voriconazole eye drops 1% alone. Healing of the fungal keratitis was considered as the primary outcome measure. Secondary outcome measures included any reported complication as well as the visual outcome.Results: Each group included 20 eyes with deep and/or resistant fungal keratitis. Complete healing of fungal keratitis was higher in group A (85%) than in group B (55%) and the difference was statistically significant (P<0.05). The duration of healing ranged between 2-4 weeks in group A and between 2-6 weeks in group B (P>0.05). Laboratory studies showed increased prevalence of filamentous fungi (70% in group A and 65% in group B) more than yeasts (30% in group A and 35% in group B), and the difference between both groups was statistically not significant (P>0.05). Conclusion:Voriconazole eye drops might be effective for treatment of deep and/or resistant fungal keratitis. Adding intrastromal injection to topical drops could significantly raise the healing rate and hasten the resolution period without significant complications related to injection.

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Voriconazole versus natamycin as primary treatment in fungal corneal ulcers

Abstract: Topical 1% voriconazole was found to be safe and effective drug in primary management of fungal keratitis, its efficacy matching conventional natamycin. There was no added advantage of using topical 1% voriconazole over topical natamycin as primary treatment in fungal keratitis.

Cited by 61 publications

References 29 publications

Outcomes of Treatment of Fungal Keratitis at the University of Iowa Hospitals and Clinics

Outcomes of Treatment of Fungal Keratitis at the University of Iowa Hospitals and Clinics

Pharmacological treatment for infectious corneal ulcers

Topical Voriconazole Drops With and Without Intrastromal Voriconazole Injection for Treatment of Deep or Resistant Fungal Keratitis

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