Natamycin in the treatment of keratomycosis: Correlation of treatment outcome and in vitro susceptibility of fungal isolates.
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Date
2011-11
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Abstract
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.
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Keywords
Keratomycosis, minimum inhibitory concentration, natamycin, susceptibility, treatment outcome
Citation
Pradhan Linu, Sharma Savitri, Nalamada Suma, Sahu Srikant K, Das Sujata, Garg Prashant. Natamycin in the treatment of keratomycosis: Correlation of treatment outcome and in vitro susceptibility of fungal isolates. Indian Journal of Ophthalmology. 2011 Nov; 59(6): 512-514.