Natamycin in the treatment of keratomycosis: correlation of treatment outcome and in vitro susceptibility of fungal isolates.
In this study, 60 fungal isolates from 60 patients with fungal keratitis were tested in vitro for their susceptibility to natamycin and the mean minimum inhibitory concentrations of natamycin (MICn) were correlated with clinical outcome. The mean MICn for various groups of fungi from patients with either early (<10 days) or late (≥ 10 days) presentation was correlated with the outcome. Aspergillus flavus showed resistance to natamycin with a high mean MICn (>16 μg/ml). While the clinical response in all patients with early A. flavus keratitis was good it was poor in late cases (5/8 patients, 62.5%). Fusarium species, Acremonium species and dematiaceous fungi were sensitive with low mean MICn (Fusarium: 5.7-7.2 μg/ml, Acremonium: 5.7-6.8 μg/ml, dematiaceous: (1.6-4 μg/ml). However, 46.6% (7/15) patients in Fusarium and 57.1% (4/7) in Acremonium group needed keratoplasty. We conclude that despite susceptibility of most fungal species causing keratitis to natamycin, the treatment outcome is poor in advanced fungal keratitis.
L. V. Prasad Eye Institute, Bhubaneswar, Orissa, India.
Linu
L
Pradhan
Savitri
S
Sharma
Suma
S
Nalamada
Srikant K
SK
Sahu
Sujata
S
Das
Prashant
P
Garg
D000935:Antifungal Agents / Q000008:administration & dosage*; D025141:Drug Resistance, Fungal; D015821:Eye Infections, Fungal / Q000188:drug therapy*; D006801:Humans; D007634:Keratitis / Q000188:drug therapy* / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D010866:Natamycin / Q000008:administration & dosage*; D009883:Ophthalmic Solutions; D011446:Prospective Studies
D000935:Antifungal Agents; D009883:Ophthalmic Solutions; D010866:Natamycin