Effect Comparison Of Oral Itraconazole Singly And In Combination With Amphotericin B Eye Drop In The Treatment Of Fungal Keratitis

Objective:To observe and compare the clinical effect of oral Itraconazole singly and in combination with Amphotericin B eye drop in the treatment of fungal keratitis.Methods:From October 2006 to September 2008, all patients with culture proved fungal keratitis were randomly divided to group A or B according to their case number series, patients in group A received oral Itraconazole(300mg/d), while patients in group B received oral Itaconazole combined with 0.15% Amphotericin B eye drop (once per 30 minutes). If the disease became more severe by one week, other therapies (adding drugs or performing operation) were adopted. Based on the disease severity and different fungal species, the cases of patients presented with signs of a favorable response by one week after the administration of initial drug therapies were compared, the cases of patients relatively cured just by initial drug therapies and their average treating time were also compared.Results:One hundred patients with culture proved fungal keratitis were recruited,48 cases in group A and 52 cases in group B, among which, mild, moderate and severe cases in group A and B were 13 (27%),18 (38%),17 (35%) and 13 (25%), 17cases(33%),22 (42%) respectively. In the two groups, cases of patients presented with signs of a favorable response by one week were 24(50%) and 38(73%) respectively. Cases of patients relatively cured just by initial drug therapy were 25(52%) and 40(77%); in mild cases, cure rate of group A and B was 92% and 77%, in moderate cases, cure rate of group A and B was 50% and 82%(this difference is significant:P=0.044), in severe cases, cure rate of group A and B was 24% and 73% (this difference is significant:P=0.002). Average treating time for mild, moderate and severe cases relatively cured by the two initial drug therapies was 29d,50d,70d and 17d,30d,64d respectively. Conclusions:In treating mild cases of fungal keratitis, oral Itraconazole singly or in combination with Amphotericin B eye drop can both eliminate infection of most cases. In treating moderate and severe cases of fungal keratitis, the clinical effect of oral Itraconazole combined with Amphotericin B eye drop is better than that of oral Itraconazole singly.