Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, Universiti Teknologi MARA, 42300 Bandar Puncak Alam, Selangor, Malaysia; Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC 3052, Australia.
Corneal Unit, Royal Victorian Eye and Ear Hospital (RVEEH), 32 Gisborne Street, East Melbourne, VIC 3002, Australia; Centre for Eye Research Australia, University of Melbourne, c/- RVEEH, Locked Bag 8, East Melbourne, VIC 3002, Australia.
Int J Antimicrob Agents. 2014 Aug;44(2):96-104. doi: 10.1016/j.ijantimicag.2014.04.008. Epub 2014 May 17.
Treatment of fungal keratitis remains challenging. To date, only the polyenes and azoles are commonly used topically in the management of fungal keratitis. Natamycin, a polyene, is the only antifungal eye drop that is commercially available; the remainder are prepared in-house and are used in an 'off-label' manner. Failure of medical treatment for fungal keratitis is common, hence there is a need for more effective topical antifungal therapy. To increase the antifungal eye drop armamentarium, it is important to investigate the utility of other classes of antifungal agents for topical use. Caspofungin, an echinocandin antifungal agent, could potentially be used to address the existing shortcomings. However, little is known about the usefulness of topically administered caspofungin. This review will briefly explore the incidence, epidemiology and antifungal treatment of fungal keratitis. It will focus primarily on evidence related to the efficacy, safety and practicality of using caspofungin eye drops in fungal keratitis.
真菌性角膜炎的治疗仍然具有挑战性。迄今为止，只有多烯类和唑类药物通常被用于真菌性角膜炎的局部治疗。那他霉素是一种多烯类药物，是唯一商业化的抗真菌眼药水；其余的都是内部制备的，并以“超说明书”的方式使用。真菌性角膜炎的药物治疗失败很常见，因此需要更有效的局部抗真菌治疗。为了增加抗真菌眼药水的种类，有必要研究其他类别的抗真菌药物用于局部使用的效果。棘白菌素类抗真菌药物卡泊芬净可能被用于解决现有不足。然而，关于局部给予卡泊芬净的有效性知之甚少。本文综述简要探讨了真菌性角膜炎的发病率、流行病学和抗真菌治疗。它主要集中在与真菌性角膜炎中使用卡泊芬净眼药水的疗效、安全性和实用性相关的证据。
