Combined Application of 5% Natamycin and 0.2% Fluconazole for the Treatment of Fungal Keratitis

Purpose: To observe the clinical efficacy of combined use of 5% natamycin and 0.2% fluconazole for the treatment of fungal keratitis. Methods:A total of 65 cases diagnosed with fungal keratitis by direct smear and/or fungus culture from January 2010 to January 2013 were enrolled in this study.The duration from the onset of symptoms to admission to our ophthalmic center ranged from 9 to 90 d (mean 29.5 ±19.1 d) in the severe group, which significantly differed from the 7 to 36 d (mean 16.6±7.1 d) in the non-severe group (P<0.01). All cases were divided into non-severe and severe groups based on the degree of corneal inflammation. All cases were treated with topical use of 5% natamycin and 0.2% fluconazole once per hour. The same clinical and examination protocols were adopted for both groups. Results:In the non-severe group,23 of the 24 patients (95.8%) were healed, and 1 (4.2%) showed treatment effica cy. In the severe group,12 of 41 patients (29.3%) were healed, 11(26.8%) showed clinical efficacy, and 18(43.9%) showed no efficacy. The patients between two groups significantly differed in terms of efficacy (P<0.01). Conclusion:Combined use of 5% natamycin and 0.2% fluconazole is efficacious in treating fungal keratitis, especially mild or moderate infections.