title: Clinical utility of caspofungin eye drops in fungal keratitis.
abstract: Treatment of fungal keratitis remains challenging. To date, only the polyenes and azoles are commonly used topically in the management of fungal keratitis. Natamycin, a polyene, is the only antifungal eye drop that is commercially available; the remainder are prepared in-house and are used in an 'off-label' manner. Failure of medical treatment for fungal keratitis is common, hence there is a need for more effective topical antifungal therapy. To increase the antifungal eye drop armamentarium, it is important to investigate the utility of other classes of antifungal agents for topical use. Caspofungin, an echinocandin antifungal agent, could potentially be used to address the existing shortcomings. However, little is known about the usefulness of topically administered caspofungin. This review will briefly explore the incidence, epidemiology and antifungal treatment of fungal keratitis. It will focus primarily on evidence related to the efficacy, safety and practicality of using caspofungin eye drops in fungal keratitis.
authors.affiliation: Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, Universiti Teknologi MARA, 42300 Bandar Puncak Alam, Selangor, Malaysia; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia.
authors.forename: Chin Fen
authors.initials: CF
authors.lastname: Neoh
authors.affiliation: Corneal Unit, Royal Victorian Eye and Ear Hospital (RVEEH), 32 Gisborne Street, East Melbourne, VIC 3002, Australia; Centre for Eye Research Australia, University of Melbourne, c/- RVEEH, Locked Bag 8, East Melbourne, VIC 3002, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Daniell
authors.affiliation: Centre for Infectious Diseases and Microbiology Laboratory Services, ICMPR - Pathology West, Westmead Hospital, P.O. Box 533, Wentworthville, NSW 2145, Australia.
authors.forename: Sharon C-A
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia.
authors.forename: Kay
authors.initials: K
authors.lastname: Stewart
authors.affiliation: Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia. Electronic address: david.kong@monash.edu.
authors.forename: David C M
authors.initials: DC
authors.lastname: Kong
mesh_terms: D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000077336:Caspofungin; D054714:Echinocandins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007634:Keratitis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D055666:Lipopeptides; D009181:Mycoses / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D009883:Ophthalmic Solutions / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D009883:Ophthalmic Solutions; D000077336:Caspofungin
keywords: Caspofungin; Corneal ulcer; Cost; Echinocandins; Keratomycosis