title: Effect of the vehicle on the topical itraconazole efficacy for treating corneal ulcers caused by Aspergillus fumigatus.
abstract: BACKGROUND
  The clinical behaviour of mycotic keratitis is aggressive, and the options for treating it are limited. This poses a need to explore new options for efficacious, low-cost treatment. Recent evidence suggests that topical itraconazole may be useful for treating this entity and that it may be possible to improve its efficacy using a suitable vehicle.
  
  
  METHODS
  We included 12 New Zealand white (NZW) rabbits (24 eyes). The rabbits were infected with pathogenic strains of Aspergillus fumigatus and subsequently randomized to receive every 2 h for 5 weeks two different preparations of topical itraconazole 1%. In group 1 (12 eyes), ricinus oil and in group 2 (12 eyes), Systane were used as vehicle. Rabbits were evaluated every week by a masked ophthalmologist to determine the treatment response.
  
  
  RESULTS
  The size of the ulcers was similar in the two groups at the baseline: group 1: 12.7 +/- 2.7 mm (median 12.8, range 9.8-15.5 mm); and group 2: 12.3 +/- 3.1 mm (median 12.1, range 9.8-20.8; P = 0.67). Although both groups responded well to the treatment, the response was better in the group 2, especially in weeks 2 and 3: week 1: 12.7 +/- 2.7 vs. 9.3 +/- 4.61 mm (P = 0.1); week 2: 9.4 +/- 3.4 vs. 4.1 +/- 2.9 mm (P = 0.004); week 3: 5.0 +/- 3.4 vs. 1.7 +/- 1.0 mm (P = 0.004); week 4: 1.9 +/- 1.9 vs. 1.0 +/- 1.2 mm (P = 0.1); and week 5: 0.68 +/- 1.2 vs. 0.0 +/- 0.0 mm (P = 0.3).
  
  
  CONCLUSIONS
  Topical itraconazole may be useful for treating corneal ulcers caused by Aspergillus fumigatus, and its efficacy seems to be related with the vehicle solubility.
authors.affiliation: Grupo Médico Claros, Instituto Mexicano del Seguro Social and Unidad de Investigación Biomédica del CEM. Mérida, Yucatán, Mexico.
authors.forename: Marimar
authors.initials: M
authors.lastname: Martínez-Ramos
authors.forename: José A
authors.initials: JA
authors.lastname: Claros-B
authors.forename: Maria Alejandra
authors.initials: MA
authors.lastname: Vale-Oviedo
authors.forename: Edgar
authors.initials: E
authors.lastname: Siso-Villarroel
authors.forename: Rubén
authors.initials: R
authors.lastname: Padilla
authors.forename: Axel
authors.initials: A
authors.lastname: Santiago
authors.forename: J-Abraham
authors.initials: JA
authors.lastname: Simón
mesh_terms: D000287:Administration, Topical; D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy*; D001232:Aspergillus fumigatus; D003320:Corneal Ulcer / Q000382:microbiology* / Q000473:pathology; D015821:Eye Infections, Fungal / Q000188:drug therapy*; D017964:Itraconazole / Q000008:administration & dosage / Q000627:therapeutic use*; D009883:Ophthalmic Solutions / Q000737:chemistry; D014677:Pharmaceutical Vehicles / Q000737:chemistry*; D010938:Plant Oils / Q000737:chemistry; D011817:Rabbits; D012278:Ricinus; D012995:Solubility; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D009883:Ophthalmic Solutions; D014677:Pharmaceutical Vehicles; D010938:Plant Oils; D017964:Itraconazole