Pharmacotherapy of Fungal Keratitis

Obrubov, A.S.; Belskaia, K.I.

doi:10.25276/0235-4160-2018-1-98-102

Cited by 5 publications

(1 citation statement)

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“…When compared with other PA, such as nystatin, pimaricin, partricin, etc., amphotericin B is the only one used for systemic and invasive mycoses [2]. Treatment with amphotericin B is very effective for ophthalmomycosis of fungal etiology, such as keratitis caused by filamentous fungi [16][17][18][19], as well as fungal diseases caused by Candida, Aspergillus, Fusarium, Cryptococcus, Mucorales, Scedosporium, Paecilomyces [20,21]. It should be noted that amphotericin B plays a special role (mainly in the treatment using lipid-associated forms of amphotericin B) in treating pulmonary mycoses, especially in aspergillosis, which is the cause of 30% of deaths in patients with aspergillosis and infected with coronavirus; the latter is especially important during a pandemic [22][23][24][25].…”

Section: The Amphotericin B Status Among Macrocyclic Drugs Of the Pol...mentioning

confidence: 99%

Antifungal Macrocycle Antibiotic Amphotericin B—Its Present and Future. Multidisciplinary Perspective for the Use in the Medical Practice

Baghirova

Kasumov

2022

Biochem. Moscow Suppl. Ser. B

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This review is devoted to a broad analysis of the results of studies of the effect of macrocyclic antifungal polyene antibiotic amphotericin B on cell membranes. A detailed study of polyenes has shown that some of them can have not only antifungal, but also antiviral and antitumor effects. Under conditions of global pandemic fungal pathology develops especially quickly and in this case leads to invasive aspergillosis, which contributes to the complication of coronavirus infection in the lungs and even secondary infection with invasive aspergillosis. The treatment of an invasive form of bronchopulmonary aspergillosis is directly related to the immunomodulatory and immunostimulating properties of the macrocyclic polyene drug amphotericin B. The article presents experimental data on the study of the biological activity and membrane properties of amphotericin B and the effect of its chemically modified derivatives, as well as liposomal forms of amphotericin B on viral, bacterial and fungal infections. The mechanism of action of amphotericin B and its analogues is based on their interaction with cellular and lipid membranes, followed by formation of ion channels of molecular size in the membranes. The importance of these studies is that polyenes are sensitive to membranes that contain sterols of a certain structure. The analysis showed that pathogenic fungal cells containing ergosterol were 10−100 times more sensitive to polyene antibiotics than host cell membranes containing cholesterol. The high sterol selectivity of the action of polyenes opens broad prospects for the use of polyene antifungal drugs in practical medicine and pharmacology in the treatment of invasive mycoses and the prevention of atherosclerosis. In this context, it should be noted that polyene antibiotics are the main tool in the study of the biochemical mechanism of changes in the permeability of cell membranes for energydependent substrates. Chemical and genetic engineering transformation of the structure of polyene antibiotic molecules opens prospects for the identification and creation of new biologically active forms of the antibiotic that have a high selectivity of action in the treatment of pathogenic infections.

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Section: The Amphotericin B Status Among Macrocyclic Drugs Of the Pol...mentioning

confidence: 99%

Antifungal Macrocycle Antibiotic Amphotericin B—Its Present and Future. Multidisciplinary Perspective for the Use in the Medical Practice

Baghirova

Kasumov

2022

Biochem. Moscow Suppl. Ser. B

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Epidemiology and treatment of fungal keratitis

Давлетшина

Samoylov

2020

Vestn. oftal'mol.

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Treatment of corneal ulcers and endophthalmitis caused by yeast fungi

Kovaleva

Krichevskaya

Исааковна³

et al. 2021

Russian Pediatric Ophthalmology

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Aim: To analyze the pathogenesis, clinical features, and treatment algorithm of fungal corneal ulcer with endophthalmitis to increase medical alertness and reduce the unjustified use of antibacterial and corticosteroid therapy in corneal diseases of various etiologies, leading to the development of secondary ophthalmomycosis. Results: The pathogenesis was analyzed, and the characteristic clinical symptoms of severe fungal corneal ulcer and endophthalmitis caused by Candida albicans were described. Intensive, long-term, unjustified antibacterial and corticosteroid therapy caused a prolonged course of herpetic corneal ulcer, as well as the addition of a secondary bacterial infection, and led to the development of severe corneal ulcer and fungal endophthalmitis in a 13-year-old child. Conclusion: The required maximum medical alertness and early, accurate clinical differential diagnosis between bacterial and fungal corneal ulcer, as well as the rapid flow of ophthalmomycosis and false-negative results of sowing content conjunctival sac entail expansion of the range and quantity of antibacterial drugs used in the absence of positive dynamics of antibiotic therapy and an increased frequency of secondary fungal infection. The clinical symptoms of a severe fungal corneal ulcer with endophthalmitis described in this report contribute to the early diagnosis of ophthalmomycosis before the type of pathogen is identified by laboratory methods, which makes it possible to start antifungal therapy earlier and avoid corneal perforation and eye loss. In most countries, due to the lack of an ocular form of antifungal drugs, for local treatment of corneal candidiasis, a 0.2% solution of fluconazole intended for intravenous administration is installed in the eyes.

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Pharmacotherapy of Fungal Keratitis

Cited by 5 publications

References 0 publications

Antifungal Macrocycle Antibiotic Amphotericin B—Its Present and Future. Multidisciplinary Perspective for the Use in the Medical Practice

Antifungal Macrocycle Antibiotic Amphotericin B—Its Present and Future. Multidisciplinary Perspective for the Use in the Medical Practice

Epidemiology and treatment of fungal keratitis

Treatment of corneal ulcers and endophthalmitis caused by yeast fungi

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