IngentaConnect Effect of the vehicle on the topical itraconazole efficacy for tr...

Authors: Martínez-Ramos, Marimar; Claros-B, José A; Vale-Oviedo, Maria Alejandra; Siso-Villarroel, Edgar; Padilla, Rubén; Santiago, Axel; Simón, J-Abraham

Source: Clinical & Experimental Ophthalmology, Volume 36, Number 4, May/June 2008 , pp. 335-338(4)

Publisher: Blackwell Publishing

Abstract:

Background:

The clinical behaviour of mycotic keratitis is aggressive, and the options for treating it are limited. This poses a need to explore new options for efficacious, low-cost treatment. Recent evidence suggests that topical itraconazole may be useful for treating this entity and that it may be possible to improve its efficacy using a suitable vehicle. Methods:

We included 12 New Zealand white (NZW) rabbits (24 eyes). The rabbits were infected with pathogenic strains of Aspergillus fumigatus and subsequently randomized to receive every 2 h for 5 weeks two different preparations of topical itraconazole 1%. In group 1 (12 eyes), ricinus oil and in group 2 (12 eyes), Systane were used as vehicle. Rabbits were evaluated every week by a masked ophthalmologist to determine the treatment response. Results:

The size of the ulcers was similar in the two groups at the baseline: group 1: 12.7 ± 2.7 mm (median 12.8, range 9.8-15.5 mm); and group 2: 12.3 ± 3.1 mm (median 12.1, range 9.8-20.8; P = 0.67). Although both groups responded well to the treatment, the response was better in the group 2, especially in weeks 2 and 3: week 1: 12.7 ± 2.7 vs. 9.3 ± 4.61 mm (P = 0.1); week 2: 9.4 ± 3.4 vs. 4.1 ± 2.9 mm (P = 0.004); week 3: 5.0 ± 3.4 vs. 1.7 ± 1.0 mm (P = 0.004); week 4: 1.9 ± 1.9 vs. 1.0 ± 1.2 mm (P = 0.1); and week 5: 0.68 ± 1.2 vs. 0.0 ± 0.0 mm (P = 0.3). Conclusion:

Topical itraconazole may be useful for treating corneal ulcers caused by Aspergillus fumigatus, and its efficacy seems to be related with the vehicle solubility.

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Effect of the vehicle on the topical itraconazole efficacy for treating corneal ulcers caused by Aspergillus fumigatus