Antifungal efficacy of voriconazole, itraconazole and amphotericin b in experimental fusarium solani keratitis.

PURPOSE: To evaluate the efficacy of topical voriconazole in an experimental rabbit model of Fusarium keratitis.

METHODS

Fungal keratitis was induced in the right eyes of 24 New Zealand rabbits. 8.6 x 10(3) CFU/0.1 ml F.solani spore suspension was injected midstromally into the central cornea. Group 1 received topical amphotericin B 0.15%, group 2 received topical itraconazole 1% and group 3 received topical voriconazole 1% hourly between 08:00 to 22:00 on days 1 and 2; 4 times daily on days 3-5. Control group received topical balanced salt solution at identical intervals. The eyes were examined clinically with a scoring system before treatment (day 0), on day 3 and on day 5. Cultures were taken from the lesion by scraping at the end of the treatment. Clinical scores and microbiologic results were analyzed statistically.

RESULTS

In the control group, keratitis progressed clinically and colony level was 2 x 10(3) CFU at day 5. In all treatment groups, progression of keratitis was inhibited clinically. Culture was sterile in the group receiving amphotericin B. Colony level was 0.3 x 10(2) CFU in the itraconazole group and 2 x 10(2) CFU in the voriconazole group at day 5.

CONCLUSION

Progression of keratitis was inhibited clinically in all treatment groups. Colony level decreased significantly in all treatment groups. As a result, itraconazole 1% and voriconazole 1% were found to be effective in Fusarium keratitis clinically and microbiologically, although their activity was not as effective as amphotericin B 0.15%.