Antifungal Therapy in Eye Infections: New Drugs, New Trends

Abstract

Treatment of ocular fungal infections represents a challenge for the ophthalmic clinician. Although an increased number of fungal infections of the eye have been reported in the past few decades, in part, because of increased clinical awareness and improved laboratory techniques, it is not matched by availability of effective ocular antifungal drugs. In addition, the need for improved antifungal therapy is emphasized by the potentially poor clinical outcome in patients with severe ocular mycoses. For an adequate therapeutic response, besides correct drug choice, an effectively administration is necessary. Current treatment for systemic fungal infections is not always sufficiently effective for ocular mycoses. The slower research and development progress in antifungal therapy compared with antibacterial therapy stems from the fact that fungal cells, unlike bacteria, are eukaryotic, consequently any drug that is toxic to fungal cells could potentially exert similar effects on mammalian cells. There also has been less financial incentive for pharmaceutical companies to invest in the development of ocular antifungal agents. Despite certain therapeutic advances, the impact of the availability of new antifungal agents on ocular mycosis is unknown. This chapter presents information about the major antifungal drugs used in eye infections, their dosages, administration routes, side effects and overall effectiveness.