Comparison of Micafungin and Fluconazole for Experimental Candida Keratitis in Rabbits

Abstract

Abstract: : Purpose: To evaluate the efficacy of subconjunctival injection of 0.1% micafungin and 0.2% fluconazole in the treatment of experimental Candida albicans keratitis in rabbits. Methods: In 24 New Zealand white rabbits, Candida albicans (5×10⁴ yeast cells) was inoculated in the corneal stroma of right eye. The animals were randomly assigned to three groups and received subconjunctival injection of 0.5 ml of 0.1% micafungin, 0.2% fluconazole, or physiologic saline once a day for three weeks. The eyes were examined slit–lamp biomicroscopically and histopathologically. Clinical course of fungal keratitis was compared between three groups. Results: The clinical scores were significantly lower in the micafungin group than the other two groups throughout the study period (P<0.0001 ∼ P=0.0027, Bonferroni’s multiple comparison test). The fluconazole group showed significantly lower clinical scores than the saline group on day 18 (P=0.0343). At the end of the study period, there were significant differences between the saline and the micafungin groups (P<0.0001), the saline and the fluconazole groups (P=0.0072), and the fluconazole and the micafungin groups (P=0.0013). Histopathologically, similar results were obtained. Subconjunctival injection of 0.1% micafungin was well tolerated and no adverse effects were observed. Conclusions: Subconjunctival administration of micafungin was effective in the treatment of experimental Candida keratitis. Topical application of micafungin would be a feasible treatment option for clinical fungal keratitis.

Keywords: antibiotics/antifungals/antiparasitics • fungal disease • keratitis