Antifúngicos em infecções oculares: drogas e vias de administração

Rosane Silvestre De Castro,Guilherme Gubert Müller,Newton Kara-José

doi:10.1590/s0034-72802013000200014

Abstract

Treatment of fungal eye infections represents a challenge to the ophthalmology practice. For an adequate therapeutic response, besides correct drug choice, it is necessary an effectively administration. This script gathers information about the major antifungal drugs used in eye infections, their concentrations and main administration routes. Antifungals in eye infections: drugs and routes of administration

Highlights

Fungal eye infections are important causes of ocular morbidity
Since the first report of a fungal keratitis by Leberin 1879(1), an increasing number of cases has been observed. Factors such as corticosteroid use, which facilitates the penetration of pathogens, and the popularisation of topical antibiotics, which create an environment of lower competition among microorganisms on the ocular surface, as suggested as key factors for such increase
This paper aims to present information on the main antifungals currently used for the treatment of fungal keratitis and endophthalmitis, highlighting their advantages and disadvantages in order to facilitate the choice of the most appropriate therapy for each case

Summary

INTRODUCTION

Fungal eye infections are important causes of ocular morbidity. Since the first report of a fungal keratitis by Leberin 1879(1), an increasing number of cases has been observed. Topical MCZ was effective in an experimental study where therapeutic concentrations were maintained even with less frequent dosing[64] It is notably effective and safe when used subconjunctivally (1.2 to 10 mg) in the treatment of infections caused by Candida, Fusarium, Curvalaria, and Aspergillus[2,61,65,66]. - Econazole ECZ, an imidazole with a similar molecular structure to MCZ, is used primarily in the treatment of superficial mycoses, with some studies involving systemic use[69] It has been little studied in the treatment of eye infections, but there are some reports of topical administration to treat fungal keratitis. - Posaconazole Similar to VCZ, PCZ is a second-generation triazole recently introduced into medical practice It results from an improvement in the molecule of ICZ and is primarily indicated for the treatment of invasive fungal infections in onco-hematological patients.

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Findings

CONCLUSION