Randomised trial of 0.2% chlorhexidine gluconate and 2.5% natamycin for fungal keratitis in bangladesh.
Aim-The management of suppurative keratitis due to filamentous fungi presents severe problems in tropical countries.
The aim was to demonstrate the efficacy of chlorhexidine 0.2% drops as an inexpensive antimicrobial agent, which could be widely distributed for fungal keratitis.
Methods-Successive patients presenting to the Chittagong Eye Institute and Training Complex with corneal ulcers were admitted to the trial when fungal hyphae had been seen on microscopy.
They were randomised to drop treatment with chlorhexidine gluconate 0.2% or the standard local treatment natamycin 2.5%. The diameters, depths, and other features of the ulcers were measured and photographed at regular intervals.
The outcome measures were healing at 21 days and presence or absence of toxicity.
If there was not a favourable response at 5 days, « treatment failure » was recorded and the treatment was changed to one or more of three options, which included econazole 1% in the latter part of the trial.
71 patients were recruited to the trial, of which 35 were randomised to chlorhexidine and 36 to natamycin.
One allocated to natamycin grew bacteria and therefore was excluded from the analysis.
None of the severe ulcers was fully healed at 21 days of treatment, but three of those allocated to chlorhexidine eventually healed in times up to 60 days.
Of the non-severe ulcers, 66.7% were healed at 21 days with chlorhexidine and 36.0% with natamycin, a relative efficacy (RE) of 1.85 (CL 1.01-3. (...)
Mots-clés Pascal : Kératite, Fusarium, Fungi Imperfecti, Fungi, Thallophyta, Aspergillus, Infection, Cornée, Oeil, Mycose, Chimiothérapie, Traitement, Chlorhexidine, Antiseptique, Voie locale, Natamycine, Antifongique, Antibactérien, Forme ophtalmique, Homme, Randomisation, Bengla Desh, Asie, Oeil pathologie, Kératopathie
Mots-clés Pascal anglais : Keratitis, Fusarium, Fungi Imperfecti, Fungi, Thallophyta, Aspergillus, Infection, Cornea, Eye, Mycosis, Chemotherapy, Treatment, Chlorhexidine, Antiseptic, Local administration, Natamycine, Antifungal agent, Antibacterial agent, Ophthalmic preparation, Human, Randomization, Bangladesh, Asia, Eye disease, Keratopathy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0401794
Code Inist : 002B02M. Création : 25/01/1999.