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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Autores principales:	Nada WM, Al Aswad MA, El-Haig WM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Fungal keratitis intrastromal injection Amphotericin B Fluconazole combined therapy. Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/834914176f1b467f87bb91c762a73b22
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spelling	oai:doaj.org-article:834914176f1b467f87bb91c762a73b222021-12-02T04:07:42ZCombined intrastromal injection of amphotericin B and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective study1177-5483https://doaj.org/article/834914176f1b467f87bb91c762a73b222017-05-01T00:00:00Zhttps://www.dovepress.com/combined-intrastromal-injection-of-amphotericin-b-and-topical-fluconaz-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Waled 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 therapyNada WMAl Aswad MAEl-Haig WMDove Medical PressarticleFungal keratitisintrastromal injectionAmphotericin BFluconazolecombined therapy.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 871-874 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Fungal keratitis intrastromal injection Amphotericin B Fluconazole combined therapy. Ophthalmology RE1-994
spellingShingle	Fungal keratitis intrastromal injection Amphotericin B Fluconazole combined therapy. Ophthalmology RE1-994 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
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
format	article
author	Nada WM Al Aswad MA El-Haig WM
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
publishDate	2017
url	https://doaj.org/article/834914176f1b467f87bb91c762a73b22
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Combined intrastromal injection of amphotericin B and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective study

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