| Objective Terbinafine has been proposed as a new antifungal drug of the allylamine class with a broad antifungal spectrum. The tablet and ointment of terbinafine was widely applied in dermatology department with good therapeutic effects. However, the application of terbinafine in ophthalmology was not fully investigated in previous research. Fluconazole is a triazole antifungal drug widely used in ophthalmology for the treatment and prevention of fungal keratitis (FK) due to good ocular penetration, long half-life and few adverse effects. It has good therapeutic effects to eurotium candida and penicillium but low sensitivity to fusarium. According to statistics, the incidence of FK has increased year by year. In addition, the pathogen already changed and FK mostly caused by eurotium and fusarium nowadays. There are only a few drugs in clinical treatment of FK and some of them are very expensive. Therefore, it does not wildly use in basic hospital. Fortunately, it was reported that there is synergistic action between terbinafine and fluconazole. Herein, it provides a significant reference to clinical application that we study in the methodologies and therapeutic effects for treating FK with the statistical analysis.Methods1. Collection of clinical cases:The samples were obtained from patients in our hospital. They were doubted because of their medical history and clinical manifestation. Corneal scrapings from patients were incubated to facilitate sporulation and identified to the species based on macroscopic and microscopic.2. Patients grouping:Two groups were divided by random and balance. In detailed, all patients were divided into experimental group and control group as mild, moderate, and severe according to the severity of FK.3. Selection of therapeutic methodologies:The terbinafine powder was prepared to0.5%terbinafine eye drops. Both terbinafine eye drops and fluconazole eye duops were frequently and alternately dropped into eye. The terbinafine tablets were orally dosed up the patients. The antibiotics and nutritional drugs were treated on whole body and regional sections. Control group obtained same treatment with experimental group except the terbinafine eye drops and tablets. The effects and process were observed and recorded.4. Data processing:The observed data was analyzed by statistics. The statistical differences between two groups were compared from therapeutic effects and process.Result Corneal scrapings from27patients were incubated to facilitate sporulation and identified to the species based on macroscopic and microscopic. Fungal keratitis was diagnosed when at least one result of the examinations was positive14of27cases beloaged to experimental group. Mild, moderate, and severe cases in experimental group were8,5,1, and lcases respectively. The other13cases were belong to control group. Mild, moderate, and severe cases in experimental group were8,4,1, and1cases respectively too. The cure rate of experimental and control group were71.43%and30.77%respectively. The cure cycle of experimental and control group were21.4days and23.1days respectively. The data was compared by statistical analysis.Conclusion The therapeutic effect of terbinafine combined with fluconazole to FK is better than only fluconazole. Especially, the therapeutic effect of two drugs for mild and moderate FK cases is obviously better than only fluconazole. The experimental group cure cycle is shorter than control group. |
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