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Reduced susceptibility to natamycin linked to larger infiltrate, perforation risk
Researchers have found that decreased susceptibility to natamycin is associated with increased 3-month infiltrate or scar size and increased chances of perforation.
The researchers enrolled 323 patients in a randomized, double-masked clinical trial to compare clinical outcomes of topical natamycin monotherapy with that of voriconazole monotherapy for the treatment of fungal keratitis. Associations between minimum inhibitory concentration (MIC) and clinical outcomes were assessed. The study’s primary outcome was best corrected visual acuity at 3 months.
At 3 months, the researchers found a two-fold increase in MIC was associated with a larger infiltrate or scar size, as well as increased chances of perforation. Visual acuity and MIC were not shown to have any correlation at 3 months, according to the researchers.
Whereas cases treated with natamycin demonstrated an association between higher natamycin MIC and larger 3-month infiltrate or scar size and increased perforations, no correlations were found between voriconazole MIC and any of the measured outcomes in the study among cases treated with voriconazole.
Disclosure: Acharya is a consultant to Xoma and Santan.