Re-appraisal of topical 1% voriconazole and 5% natamycin in the treatment of fungal keratitis in a randomised trial

The British Journal of Ophthalmology
Savitri SharmaSwapna R Motukupally

Abstract

To compare the efficacy of topical 1% voriconazole vs 5% natamycin for the treatment of fungal keratitis. In a prospective, double-masked, randomised, controlled, registered clinical trial, 118 patients with fungal keratitis were treated using identical dosage schedule with either voriconazole (58) or natamycin (60) as inpatients for 7 days and followed up weekly. The outcome measures were percentage of patients with healed or resolving ulcer and final visual acuity at last follow-up (primary) and on day 7 (secondary) in each group. More patients (p=0.005) on natamycin (50/56, 89.2%) had healed or resolving ulcer compared with voriconazole (34/51, 66.6%) at last follow-up. The improvement in vision was marginally greater in patients in the natamycin group compared with the voriconazole group at day 7 (p=0.04) and significantly greater at final visit (p=0.01). In univariate analysis, drug, age and mean size of corneal infiltrate and epithelial defect had a significant effect on the final visual outcome. In multivariate analysis, the effect of drug (voriconazole vs natamycin, adjusted coefficient 0.27 (-0.04 to 0.57), p=0.09) was marginal while the effect of age and epithelial defect was significant (p<0.001 for both). In the gro...Continue Reading

References

May 1, 1975·American Journal of Ophthalmology·B R Jones
Feb 28, 2002·Expert Opinion on Investigational Drugs·Holly L Hoffman, R Chris Rathbun
May 8, 2003·Journal of Clinical Microbiology·Eric NulensPaul E Verweij
Jun 7, 2003·Cornea·Tze Foon LaiDinesh Selva
May 24, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Rocus R KlontPaul E Verweij
Dec 24, 2005·Cornea·Zeynep OzbekKristin M Hammersmith
Dec 27, 2005·Antimicrobial Agents and Chemotherapy·William SponselFrank Scribbick
Apr 4, 2006·Ophthalmology·Prajna LalithaMuthaiah Srinivasan
Dec 26, 2006·American Journal of Ophthalmology·Vatinee Y BunyaElisabeth J Cohen
Jun 15, 2007·Archives of Ophthalmology·Prajna LalithaThomas M Lietman
Jan 14, 2009·Antimicrobial Agents and Chemotherapy·Yan XuBingliang Wang
Aug 6, 2009·Cornea·Allison R LohNisha R Acharya
Jun 16, 2010·Archives of Ophthalmology·Namperumalsamy V PrajnaNisha R Acharya
May 28, 2013·JAMA Ophthalmology·N Venkatesh PrajnaUNKNOWN Mycotic Ulcer Treatment Trial Group

❮ Previous
Next ❯

Citations

Jul 25, 2015·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·N CvetkovaT Dietrich-Ntoukas
Jun 5, 2016·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·L DaasA Viestenz
Apr 8, 2016·PLoS Pathogens·Abdullah M S Al-HatmiG Sybren de Hoog
Feb 18, 2018·Mycopathologia·Elif ErdemReha Ersoz
Jul 12, 2018·Mycoses·Shahram MahmoudiAli Banafsheafshan
Aug 24, 2016·Antimicrobial Agents and Chemotherapy·Chin Fen NeohDavid C M Kong
Jul 28, 2017·Journal of Clinical Microbiology·Grit WaltherMarie von Lilienfeld-Toal
Dec 19, 2018·Medwave·José RetamalArturo Grau-Diez
May 31, 2019·Eye & Contact Lens·Hui Gim KhorLee Ling Chieng
Apr 20, 2016·Current Opinion in Ophthalmology·Prashant GargSanhita Roy
Oct 24, 2020·Journal of Fungi·Valeri SáenzAdriana Marcela Celis Ramírez
Feb 5, 2021·International Journal of Pharmaceutics·Victoria Díaz-ToméFrancisco J Otero-Espinar
May 1, 2021·Journal of Fungi·Jeremy J HoffmanAstrid Leck
Apr 30, 2021·Indian Journal of Ophthalmology·Manali HazarikaSrinivasan Senthilkumari
Jun 8, 2021·Critical Reviews in Microbiology·Roxana G VitaleG Sybren de Hoog
Jun 3, 2021·Clinical Microbiology Reviews·Sixto M LealPeter H Gilligan
Sep 8, 2021·Mycopathologia·Amelie P BrackinJohanna Rhodes

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.