Pharmacotherapy of Fungal Keratitis

Abstract

The article presents a review of the literature on the various possibilities in application of antifungal drugs in the treatment of fungal keratitis. The fungal infection of the eye is one of the problems unsolved in the modern ophthalmology, which often leads not only to blindness, but to the loss of the eye as an organ. Despite decades of experience in the pharmacological treatment of fungal keratitis, the question of the officinal production of ophthalmic antifungal drugs has not yet been resolved. An ophthalmologist who has such patients is forced to search for resources available to him to provide medical care. As can be inferred from the literature, nowadays the drugs of first choice are natamycin, amphotericin B, fluconazole, and voriconazole. However, neither dosing nor modes of administration of these drugs are still standardized. It is also necessary to take into account possible side effects in their local and systemic application. Despite advances in the diagnosis and therapeutic treatment of mycotic keratitis, up to 27% of patients still require surgical interventions. But postoperative recurrences of the infection process can occur. More research (and closer attention from pharmaceutical companies) is needed to further investigate the routes of administration, concentrations and effective combinations of antifungal drugs as well as the improvement of the methods of diagnosing fungal infection.

Keywords

• corneal infections
• fungal keratitis
• mycotic keratitis
• amphotericin b
• natamycin
• voriconazole
• fluconazole