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Amphotericin B and natamycin are not synergistic in vitro against Fusarium and Aspergillus spp. isolated from keratitis
  1. Prajna Lalitha1,
  2. Brett L Shapiro2,
  3. Allison R Loh2,
  4. Annette W Fothergill3,
  5. N Venkatesh Prajna1,
  6. M Srinivasan1,
  7. Catherine E Oldenburg2,
  8. David A Quigley2,
  9. Jaya D Chidambaram2,
  10. Stephen D McLeod2,
  11. Nisha R Acharya2,
  12. Thomas M Lietman2
  1. 1Aravind Eye Care System, Madurai, India
  2. 2University of California San Francisco (UCSF), San Francisco, California, USA
  3. 3University of Texas Health Sciences Center San Antonio (UTHSCSA), San Antonio, Texas, USA
  1. Correspondence to Professor Thomas M Lietman, F.I. Proctor Foundation, Room S309, 513 Parnassus Ave, UCSF, San Francisco, CA 94143-0412, USA; tom.lietman{at}ucsf.edu

https://doi.org/10.1136/bjo.2010.195214

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    Introduction

    Infectious keratitis is a major cause of monocular blindness worldwide.1 Although fungal ulcers are relatively uncommon in developed nations, they occur frequently in developing countries, especially those in tropical regions. In South India, up to half of infectious ulcers are fungal.2 Fungal ulcers are notoriously difficult to treat compared with bacterial ulcers, and physicians frequently use combination therapy.3 Amphotericin B and natamycin are two commonly used topical agents to treat filamentous fungal keratitis.3 However, combination therapy may increase the risk of potential drug toxicity as well as the cost of therapy. Currently, there are no data on whether natamycin and amphotericin B interact synergistically in vitro against filamentous fungi.

    Here, we investigate whether amphotericin B and natamycin interact synergistically in vitro when tested against Fusarium and Aspergillus spp. isolated from patients with fungal keratitis.

    Methods

    Ten Fusarium spp. and ten Aspergillus spp. isolates were randomly selected from 98 consecutive cases of culture-positive fungal keratitis treated at Aravind Eye Hospital in South India. All patients underwent cornea culture and were treated with natamycin, …

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    Footnotes

    • Funding Supported in part by an unrestricted grant from That Man May See, Inc., San Francisco, California; an unrestricted grant from Research to Prevent Blindness, New York; and the National Institutes of Health (NIH) grant U10 EY015114.

    • Competing interests None.

    • Ethics approval Obtained from the University of California, San Francisco Committee on Human Research and the Aravind Eye Care System, Madurai Institutional Review Board.

    • Provenance and peer review Not commissioned; not externally peer reviewed.