Combined intrastromal injection of amphotericin B and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective study
Waled Mahdy Nada, Mahmoud A Al Aswad, Wael M El-Haig Ophthalmology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt Purpose: To evaluate the efficacy of combination therapy of a single intrastromal injection of amphotericin B and topical fluconazole in resistant cases of fungal...
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doaj-834914176f1b467f87bb91c762a73b222020-11-25T00:30:35ZengDove Medical PressClinical Ophthalmology1177-54832017-05-01Volume 1187187432705Combined intrastromal injection of amphotericin B and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective studyNada WMAl Aswad MAEl-Haig WMWaled Mahdy Nada, Mahmoud A Al Aswad, Wael M El-Haig Ophthalmology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt Purpose: To evaluate the efficacy of combination therapy of a single intrastromal injection of amphotericin B and topical fluconazole in resistant cases of fungal keratitis, and also topical amphotericin B as monotherapy in terms of the duration of the recovery period and toxic drug effects.Methods: This retrospective 2-year study reviewed 68 cases of unilateral fungal keratitis diagnosed by clinical features and positive laboratory culture results. Forty-one cases were resistant and did not respond to monotherapy with an antifungal agent. Thus, they were treated with a single intrastromal injection of amphotericin B in addition to topical fluconazole as combined antifungal therapy, representing group A. Twenty-seven cases were treated with topical amphotericin B as antifungal monotherapy, representing group B. Topical atropine 1% and different antibiotic eye drops were added to the antifungal agents in both groups. Follow-up of patient records was performed monitoring cure rate, duration of recovery period, and toxic drug effects such as pain, burning sensation, and corneal melting.Results: The results revealed that group A, treated with combination therapy, showed recovery of 34 cases (82.9%) with a mean duration of 24±6.42 days, significantly different from group B which showed recovery of 16 cases (59.3%) with a mean duration of 39.66±13.6 days. Group A also showed less manifestation of drug toxicity than group B.Conclusion: Combined intrastromal injection of amphotericin B and topical fluconazole can provide a good modality in the treatment of resistant cases of fungal keratitis, exhibiting highly potent antifungal effects, shorter recovery period, and reduced corneal toxicity. Keywords: fungal keratitis, intrastromal injection, amphotericin B, fluconazole, combined therapyhttps://www.dovepress.com/combined-intrastromal-injection-of-amphotericin-b-and-topical-fluconaz-peer-reviewed-article-OPTHFungal keratitisintrastromal injectionAmphotericin BFluconazolecombined therapy. |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nada WM Al Aswad MA El-Haig WM |
spellingShingle |
Nada WM Al Aswad MA El-Haig WM Combined intrastromal injection of amphotericin B and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective study Clinical Ophthalmology Fungal keratitis intrastromal injection Amphotericin B Fluconazole combined therapy. |
author_facet |
Nada WM Al Aswad MA El-Haig WM |
author_sort |
Nada WM |
title |
Combined intrastromal injection of amphotericin B and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective study |
title_short |
Combined intrastromal injection of amphotericin B and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective study |
title_full |
Combined intrastromal injection of amphotericin B and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective study |
title_fullStr |
Combined intrastromal injection of amphotericin B and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective study |
title_full_unstemmed |
Combined intrastromal injection of amphotericin B and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective study |
title_sort |
combined intrastromal injection of amphotericin b and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective study |
publisher |
Dove Medical Press |
series |
Clinical Ophthalmology |
issn |
1177-5483 |
publishDate |
2017-05-01 |
description |
Waled Mahdy Nada, Mahmoud A Al Aswad, Wael M El-Haig Ophthalmology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt Purpose: To evaluate the efficacy of combination therapy of a single intrastromal injection of amphotericin B and topical fluconazole in resistant cases of fungal keratitis, and also topical amphotericin B as monotherapy in terms of the duration of the recovery period and toxic drug effects.Methods: This retrospective 2-year study reviewed 68 cases of unilateral fungal keratitis diagnosed by clinical features and positive laboratory culture results. Forty-one cases were resistant and did not respond to monotherapy with an antifungal agent. Thus, they were treated with a single intrastromal injection of amphotericin B in addition to topical fluconazole as combined antifungal therapy, representing group A. Twenty-seven cases were treated with topical amphotericin B as antifungal monotherapy, representing group B. Topical atropine 1% and different antibiotic eye drops were added to the antifungal agents in both groups. Follow-up of patient records was performed monitoring cure rate, duration of recovery period, and toxic drug effects such as pain, burning sensation, and corneal melting.Results: The results revealed that group A, treated with combination therapy, showed recovery of 34 cases (82.9%) with a mean duration of 24±6.42 days, significantly different from group B which showed recovery of 16 cases (59.3%) with a mean duration of 39.66±13.6 days. Group A also showed less manifestation of drug toxicity than group B.Conclusion: Combined intrastromal injection of amphotericin B and topical fluconazole can provide a good modality in the treatment of resistant cases of fungal keratitis, exhibiting highly potent antifungal effects, shorter recovery period, and reduced corneal toxicity. Keywords: fungal keratitis, intrastromal injection, amphotericin B, fluconazole, combined therapy |
topic |
Fungal keratitis intrastromal injection Amphotericin B Fluconazole combined therapy. |
url |
https://www.dovepress.com/combined-intrastromal-injection-of-amphotericin-b-and-topical-fluconaz-peer-reviewed-article-OPTH |
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