Comparison of efficacy of topical and oral fluconazole treatment in experimental Aspergillus keratitis.
OBJECTIVE
To investigate the therapeutic role of topical and oral fluconazole treatment using a rabbit model of Aspergillus fumigatus keratitis.


METHODS
Aspergillus fumigatus spores were injected into the corneal stroma of the right eye of 20 rabbits. Forty-eight hours later the rabbits were randomly divided into three groups. Group 1 rabbits (six) were treated with topical fluconazole (2 mg/ml, eight times daily), group 2 rabbits (seven) received oral fluconazole (37.5 mg/kg bid), and group 3 rabbits (seven) were untreated controls. The eyes were examined and photographed with a slit-lamp 2, 6, 10, 16, and 20 days after inoculation and an observer graded the corneas in a masked fashion. Corneal cultures were taken on days 2, 14, and 20 for fungus growth.


RESULTS
At the beginning of treatment, the slit-lamp scores did not differ among three groups. However, on days 6, 10, 16, and 20 the treated groups had statistically significant lower scores compared to the untreated controls. No significant difference was observed between topical and oral treated groups at any examination point. All cultures were positive on day 2, but on days 16 and 20, there were significantly lower positive fungal cultures in both treatment groups compared to the control (p < 0.01, chi square test).


CONCLUSIONS
Our study showed that both topical and oral fluconazole were effective in lessening the severity of fungal keratitis in a rabbit model and should be considered effective treatment alternatives in the therapy of Aspergillus fumigatus keratitis.
Avunduk
Avni Murat
AM
Department of Ophthalmology, LSU Medical School, New Orleans, LA, USA. avni_murat_avunduk@hotmail.com
Beuerman
Roger W
RW
Warnel
Emily D
ED
Kaufman
Herbert E
HE
Greer
Donald
D
D000284:Administration, Oral; D000287:Administration, Topical; D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy*; D001232:Aspergillus fumigatus / Q000502:physiology; D003315:Cornea / Q000187:drug effects / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000188:drug therapy*; D015725:Fluconazole / Q000008:administration & dosage* / Q000627:therapeutic use; D007634:Keratitis / Q000188:drug therapy* / Q000382:microbiology; D008297:Male; D011817:Rabbits
D000935:Antifungal Agents; D015725:Fluconazole