Clinical efficacy of Voriconazole with Natamycin for the treatment of fungal corneal ulcer

Abstract

Objective To investigate the clinical efficacy of Voriconazole combined with Natamycin for the treatment of fungal corneal ulcer after eye injury. Methods 22 eyes of 22 patients with fungal corneal ulcer were treated with Voriconazole systematically, first day 800 mg/d （400 rag, bid） , then 400 mg/d （200 rag, bid）, for 14-21 days according to the severity, combined with Natamycin eye drops application topically. The initial administration of Natamycin were once an hour. If the clinical symptoms were significantly improved after 14 days, it were reduced to 6 - 8 times/d for 3-4 weeks. If the inflammation subsided, the frequency of administration might be reduced gradually, and maintained for 3 weeks after the mycelium were not found by confocal microscopy. Corneal debridement and iodine tincture cautery were performed. And the efficacy of combined medication were observed. Results 17 eyes were clinically cured （77.27%）. The treatments of 5 eyes were ineffective, in which 3 eyes received evisceration, and 2 eyes received corneal transplantation. No serious adverse drug reaction occured in all patients. Conclusion Systemic medication of Voriconazole combined with Natamycin eye dorps for the treatment of fungal corneal ulcer is safe and effective. It is a new choice for refractory fungal corneal ulcer. Key words: Ulcer,corneal, fungal; Voriconazole; Natamycin; Efficacy