Role of voriconazole in combined acanthamoeba and fungal corneal ulcer

Gupta, Shikha; Shrivastava, Rajat Mohan; Tandon, Radhika; Gogia, Varun; Agarwal, Pooja; Satpathy, Gita

doi:10.1016/j.clae.2011.06.004

Cited by 25 publications

(9 citation statements)

References 20 publications

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“…Voriconazole ophthalmic drops have not yet been marketed but promising results obtained with the use of voriconazole drops prepared by reconstitution of Vfend powder in several clinical studies have demonstrated the need for topical formulations [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Design and Evaluation of Voriconazole Eye Drops for the Treatment of Fungal Keratitis

Malhotra

Khare

Grover

et al. 2014

Journal of Pharmaceutics

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Voriconazole is a novel antifungal agent with excellent broad spectrum activity commercially available for oral and intravenous administration. The purpose of this study was to prepare ophthalmic formulation of hydroxypropyl beta cyclodextrin (HP-β-CD) based voriconazole containing benzalkonium chloride BAK and EDTA with or without viscosity modifiers and study its permeation characteristics through freshly excised goat cornea. The results were observed that viscosity and force of bioadhesion of the voriconazole HP-β-CD solutions containing xanthan gum (XG) are more as compared to polyvinyl alcohol. The results revealed that voriconazole drop containing PVA provided least viscosity and higher corneal permeation of drug, while drop formulated with XG had maximum viscosity and least permeation. The HP-β-CD based voriconazole (1.5%) ophthalmic formulation containing xanthan gum (1.5), preserved with BAK and EDTA, could provide shelf life of 2 years. The microbiological studies showed that voriconazole ophthalmic solution containing xanthan gum shows better antifungal activity as compared to voriconazole and xanthan gum alone. Thus, it can be concluded that HP-β-CD based voriconazole (1.5%, pH 7.0) ophthalmic solution containing BAK and EDTA with viscosity modifier XG provided maximum precorneal residence time as compared to other viscosity modifiers and polyvinyl alcohol provided less precorneal residence time than other viscosity modifiers.

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Section: Introductionmentioning

confidence: 99%

Design and Evaluation of Voriconazole Eye Drops for the Treatment of Fungal Keratitis

Malhotra

Khare

Grover

et al. 2014

Journal of Pharmaceutics

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“…For example, several azole compounds, including miconazole nitrate, ketoconazole, clotrimazole, fluconazole, and voriconazole, have been tested that target 14-␣ demethylase, a cytochrome P-450 enzyme necessary to convert lanosterol to ergosterol, inhibiting phospholipid and triglyceride synthesis and affecting oxidative and peroxidative enzyme activities, resulting in deterioration of subcellular components and leading to cell necrosis. Although several azole compounds showed amoebicidal effects at a concentration as low as 10 g per ml in vitro, they showed cysticidal properties at a far higher concentration of 1,000 g per ml (19,20,27,31,33,40,(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61). Among the ergosterol inhibitors, amphotericin B has been tested and has been shown to bind to ergosterol, forming a transmembrane channel that leads to monovalent ion leakage, which is the primary effect leading to cell death.…”

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confidence: 99%

The Development of Drugs against Acanthamoeba Infections

Siddiqui

Aqeel

Khan

2016

Antimicrob Agents Chemother

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For the past several decades, there has been little improvement in the morbidity and mortality associated with Acanthamoeba keratitis and Acanthamoeba encephalitis, respectively. The discovery of a plethora of antiacanthamoebic compounds has not yielded effective marketed chemotherapeutics. The rate of development of novel antiacanthamoebic chemotherapies of translational value and the lack of interest of the pharmaceutical industry in developing such chemotherapies have been disappointing. On the other hand, the market for contact lenses/contact lens disinfectants is a multi-billion-dollar industry and has been successful and profitable. A better understanding of drugs, their targets, and mechanisms of action will facilitate the development of more-effective chemotherapies. Here, we review the progress toward phenotypic drug discovery, emphasizing the shortcomings of useable therapies.

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“…Acanthamoeba keratitis is also recalcitrant to therapy, and a number of authors consider that keratoplasty is best delayed until the organism is eradicated 18–20. However, our patient fared well with keratoplasty.…”

Section: Discussionmentioning

confidence: 74%

Pythium insidiosumandAcanthamoebakeratitis in a contact lens user

et al. 2018

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The oomycete Pythium and the protozoan Acanthamoeba can cause fulminant and recalcitrant keratitis, respectively. These infections are not only sight-threatening but can also threaten the structural integrity of the eye. A high index of suspicion is required to identify Pythium keratitis given its uncommon occurrence. Acanthamoeba keratitis is most commonly associated with contact lens wear. However, its coexistence with Pythium has not been reported. We present the successful management of a case of contact lens-related keratitis, coinfected with Pythium and Acanthamoeba.

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Role of voriconazole in combined acanthamoeba and fungal corneal ulcer

Cited by 25 publications

References 20 publications

Design and Evaluation of Voriconazole Eye Drops for the Treatment of Fungal Keratitis

Design and Evaluation of Voriconazole Eye Drops for the Treatment of Fungal Keratitis

The Development of Drugs against Acanthamoeba Infections

Pythium insidiosumandAcanthamoebakeratitis in a contact lens user

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