Influence of the corneal epithelium on the efficacy of topical antifungal agents.
A model of deep stromal Candida albicans infection was established by injecting 25 microliters of a suspension containing 5 X 10(9) colony forming units/ml of the yeast into corneas of pigmented rabbits. In this model, the infection lasts for more than 8 days. Using quantitative techniques, the authors compared the efficacy of six topical antifungal agents in the presence of an intact epithelium and in corneas debrided of epithelium. In corneas debrided on a daily basis, the polyenes (amphotericin B 0.15% and 0.075% and natamycin 5%) exhibited a significant antifungal effect. When the epithelium was left intact, 5% natamycin and 0.075% amphotericin B were without effect, while the efficacy of the 0.15% preparation of amphotericin B was much reduced. Removal of the epithelium appeared to affect adversely the efficacy of flucytosine. The imidazoles were not efficacious in this model.
D000287:Administration, Topical; D000666:Amphotericin B / Q000008:administration & dosage / Q000378:metabolism; D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage / Q000378:metabolism*; D002177:Candidiasis / Q000188:drug therapy; D003315:Cornea / Q000378:metabolism*; D003316:Corneal Diseases / Q000188:drug therapy; D004464:Econazole / Q000008:administration & dosage / Q000378:metabolism; D004848:Epithelium / Q000378:metabolism; D005437:Flucytosine / Q000008:administration & dosage / Q000378:metabolism; D007654:Ketoconazole / Q000008:administration & dosage / Q000378:metabolism; D008825:Miconazole / Q000008:administration & dosage / Q000378:metabolism; D010866:Natamycin / Q000008:administration & dosage / Q000378:metabolism; D011817:Rabbits
D000935:Antifungal Agents; D004464:Econazole; D008825:Miconazole; D000666:Amphotericin B; D010866:Natamycin; D005437:Flucytosine; D007654:Ketoconazole