Day S, Lalitha P, Haug S, Fothergill A W, Cevallos V, Vijayakumar R, Prajna N V, Acharya N R, McLeod S D, Lietman T M
Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA.
Br J Ophthalmol. 2009 Jan;93(1):116-9. doi: 10.1136/bjo.2008.142364. Epub 2008 Oct 24.
BACKGROUND/AIMS: To study the susceptibility of Fusarium and Aspergillus isolated from keratitis to amoxicillin, cefazolin, chloramphenicol, moxifloxacin, tobramycin and benzalkonium chloride (BAK).
10 isolates of Fusarium and 10 isolates of Aspergillus from cases of fungal keratitis at Aravind Eye Hospital in South India were tested using microbroth dilution for susceptibility to amoxicillin, cefazolin, chloramphenicol, moxifloxacin, tobramycin and BAK. The minimum inhibitory concentration (MIC) median and 90th percentile were determined.
BAK had the lowest MIC for both Fusarium and Aspergillus. Chloramphenicol had activity against both Fusarium and Aspergillus, while moxifloxacin and tobramycin had activity against Fusarium but not Aspergillus.
The susceptibility of Fusarium to tobramycin, moxifloxacin, chloramphenicol and BAK and of Aspergillus to chloramphenicol and BAK may explain anecdotal reports of fungal ulcers that improved with antibiotic treatment alone. While some of the MICs of antibiotics and BAK are lower than the typically prescribed concentrations, they are not in the range of antifungal agents such as voriconazole, natamycin and amphotericin B. Antibiotics may, however, have a modest effect on Fusarium and Aspergillus when used as initial treatment prior to identification of the pathological organism.
背景/目的：研究从角膜炎患者中分离出的镰刀菌和曲霉菌对阿莫西林、头孢唑林、氯霉素、莫西沙星、妥布霉素和苯扎氯铵（BAK）的敏感性。
使用微量肉汤稀释法对印度南部阿拉文德眼科医院真菌性角膜炎病例中分离出的10株镰刀菌和10株曲霉菌进行测试，以检测其对阿莫西林、头孢唑林、氯霉素、莫西沙星、妥布霉素和BAK的敏感性。测定最低抑菌浓度（MIC）中位数和第90百分位数。
BAK对镰刀菌和曲霉菌的MIC最低。氯霉素对镰刀菌和曲霉菌均有活性，而莫西沙星和妥布霉素对镰刀菌有活性，但对曲霉菌无活性。
镰刀菌对妥布霉素、莫西沙星、氯霉素和BAK以及曲霉菌对氯霉素和BAK的敏感性，可能解释了仅用抗生素治疗真菌性溃疡病情改善的传闻报道。虽然一些抗生素和BAK的MIC低于通常规定的浓度，但它们不在伏立康唑、那他霉素和两性霉素B等抗真菌药物的范围内。然而，在鉴定病原菌之前，抗生素作为初始治疗时可能对镰刀菌和曲霉菌有一定作用。
