title: Mycotic keratitis: susceptibility to antiseptic agents.
abstract: Oculomycosis is a severe problem in most developing countries. Specific antifungal agents are often unavailable, and are expensive. The use of antiseptic agents was therefore explored. Fungal isolates from patients in India and Ghana were tested against chlorhexidine, povidone iodine, propamidine, and polyhexamethylenebiguanide, and compared with econazole by placing the drugs in wells made in Sabouraud's agar plates seeded with the test organism. Fungal sensitivity testing is a contentious area but this method is simple and cheap. Chlorhexidine showed a good dose related response, povidone iodine showed a good response at all concentrations and econazole was the most effective in vitro. A small pilot study was conducted in India to assess clinical efficacy for fungal corneal ulcers. Both chlorhexidine and econazole proved effective but povidone iodine was ineffective. We suggest that chlorhexidine may be a useful first line agent for fungal keratitis when other antifungals are not available.
authors.affiliation: International Centre for Eye Health, Institute of Ophthalmology, Bath St., London, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Martin
authors.forename: M R
authors.initials: MR
authors.lastname: Rahman
authors.forename: G J
authors.initials: GJ
authors.lastname: Johnson
authors.forename: M
authors.initials: M
authors.lastname: Srinivasan
authors.forename: Y M
authors.initials: YM
authors.lastname: Clayton
mesh_terms: D000891:Anti-Infective Agents, Local / Q000494:pharmacology / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001550:Benzamidines / Q000494:pharmacology / Q000627:therapeutic use; D001645:Biguanides / Q000494:pharmacology / Q000627:therapeutic use; D002710:Chlorhexidine / Q000494:pharmacology / Q000627:therapeutic use; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000382:microbiology; D004202:Disinfectants / Q000494:pharmacology / Q000627:therapeutic use*; D004464:Econazole / Q000494:pharmacology / Q000627:therapeutic use; D015821:Eye Infections, Fungal / Q000188:drug therapy* / Q000209:etiology; D005658:Fungi / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008826:Microbial Sensitivity Tests; D009181:Mycoses / Q000188:drug therapy* / Q000209:etiology; D010865:Pilot Projects; D011206:Povidone-Iodine / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000891:Anti-Infective Agents, Local; D000935:Antifungal Agents; D001550:Benzamidines; D001645:Biguanides; D004202:Disinfectants; C031233:polihexanide; D004464:Econazole; D011206:Povidone-Iodine; C005555:propamidine; D002710:Chlorhexidine