The efficacy of voriconazole in 24 ocular Fusarium infections View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-06-21

AUTHORS

P. Troke, G. Obenga, T. Gaujoux, P. Goldschmidt, A.-L. Bienvenu, M. Cornet, F. Grenouillet, D. Pons, S. Ranque, K. Sitbon, C. Chaumeil, V. Borderie, O. Lortholary

ABSTRACT

PurposeWe examined, retrospectively, the efficacy of voriconazole in Fusarium eye infections.MethodsVoriconazole-treated patients with proven or probable keratitis or endophthalmitis from the voriconazole database (9 patients) and six French ophthalmology departments (15 patients) were included. Sociodemographic features, predisposing factors, history of corneal trauma, associated ocular conditions, other diseases and prior therapies were analysed. Investigator-determined success was defined as infection resolution with medical treatment. Failure was no response or persistent infection and required surgery.ResultsMost patients were Caucasian (83 %) and male (71 %). The infection was keratitis (63 %) or endophthalmitis (37 %) and proven in 23 (96 %). Prior therapy included topical and/or systemic amphotericin (46 %), fluconazole (17 %) or others (33 %), often in combination. Causative fungi were Fusarium solani (14, 58 %), Fusarium moniliforme (1), Fusarium oxysporum (1) and Fusarium spp. (8). Voriconazole was administered systemically, topically and/or by intraocular injection, and 16 patients (67 %) received salvage and eight primary therapy. The overall response was 67 % (73 % keratitis and 56 % endophthalmitis) but seven patients required adjunctive surgery. However, response was 63 % for eight primary therapy patients and 69 % for 16 salvage therapy patients. Response by species was Fusarium solani 64 % (9/14) and all others 80 % (8/10). In 13 patients (77 %), voriconazole was used in combination (response 69 vs. 64 % alone) with topical [amphotericin B 10/24 (42 %), caspofungin 5 (21 %), natamycin 1 (4 %)] and systemic agents [caspofungin 3 (13 %), amphotericin 2 (8 %)].ConclusionsTopical and systemic voriconazole appears to be effective alone or in combination with other agents for treating severe Fusarium keratitis or endophthalmitis. More... »

PAGES

15-20

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s15010-012-0273-2

DOI

http://dx.doi.org/10.1007/s15010-012-0273-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1034063102

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22718362


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30 Fusarium infection
31 Fusarium keratitis
32 Fusarium moniliforme
33 Fusarium oxysporum
34 Fusarium solani
35 Fusarium spp
36 PurposeWe
37 ResultsMost patients
38 adjunctive surgery
39 agents
40 amphotericin
41 causative fungus
42 combination
43 conditions
44 corneal trauma
45 database
46 disease
47 efficacy
48 efficacy of voriconazole
49 endophthalmitis
50 eye infections
51 factors
52 failure
53 features
54 fluconazole
55 fungi
56 history
57 infection
58 infection resolution
59 injection
60 intraocular injection
61 keratitis
62 males
63 medical treatment
64 moniliforme
65 ocular conditions
66 ophthalmology department
67 overall response
68 oxysporum
69 patients
70 persistent infection
71 primary therapy
72 prior therapy
73 resolution
74 response
75 salvage
76 salvage therapy patients
77 sociodemographic features
78 solani
79 species
80 spp
81 success
82 surgery
83 systemic agents
84 systemic amphotericin
85 systemic voriconazole
86 therapy
87 therapy patients
88 trauma
89 treatment
90 voriconazole
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