The Search for Antifungal Prophylaxis After Artificial Corneal Surgery-An In Vitro Study.


Journal

Cornea
ISSN: 1536-4798
Titre abrégé: Cornea
Pays: United States
ID NLM: 8216186

Informations de publication

Date de publication:
Dec 2020
Historique:
pubmed: 10 8 2020
medline: 6 8 2021
entrez: 10 8 2020
Statut: ppublish

Résumé

To evaluate the antifungal properties of topical antibiotics (already being used successfully to prevent bacterial endophthalmitis) and some promising antiseptics for antifungal prophylaxis in the setting of artificial corneal implantation. Several commonly used antibiotics for antimicrobial prophylaxis after artificial corneal implantation, in addition to antiseptics [benzalkonium chloride (BAK), povidone-iodine (PI), and some ionic liquids (ILs)], were tested in vitro against Candida albicans, Fusarium solani, and Aspergillus fumigatus. The time-kill activity was determined. Toxicity was assayed in vitro on human corneal epithelial cultures using trypan blue. Adhesion and tissue invasion experiments were also carried out on porcine corneas and commonly used contact lenses, with or without gamma irradiation, and by analysis with fluorescence microscopy. Polymyxin B (PMB)/trimethoprim/BAK (Polytrim), PMB alone, gatifloxacin with BAK (Zymaxid), and same-concentration BAK alone exhibited antifungal activity in vitro. Moxifloxacin (MOX) or gatifloxacin without BAK-as well as trimethoprim, vancomycin, and chloramphenicol-had no effect. 1% PI and ILs had the highest efficacy/toxicity ratios (>1), and Polytrim was species dependent. Subfungicidal concentrations of Polytrim reduced adhesion of C. albicans to Kontur contact lenses. Gamma-irradiated corneas showed enhanced resistance to fungal invasion. Of antibiotic preparations already in use for bacterial prophylaxis after KPro surgery, Polytrim is a commonly used antibiotic with antifungal effects mediated by both PMB and BAK and may be sufficient for prophylaxis. PI as a 1% solution seems to be promising as a long-term antifungal agent. Choline-undecanoate IL is effective and virtually nontoxic and warrants further development.

Identifiants

pubmed: 32769678
doi: 10.1097/ICO.0000000000002433
pii: 00003226-202012000-00012
doi:

Substances chimiques

Antifungal Agents 0
Benzalkonium Compounds 0
Drug Combinations 0
Polytrim eyedrops 53320-96-0
Trimethoprim AN164J8Y0X
Polymyxin B J2VZ07J96K
Gatifloxacin L4618BD7KJ

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1547-1555

Références

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Auteurs

Sarah Kim (S)

The Boston Keratoprosthesis Laboratory, Department of Ophthalmology, Massachusetts Eye & Ear, Boston, MA.
Harvard Medical School, Boston, MA.

Paulo J M Bispo (PJM)

Harvard Medical School, Boston, MA.
Infectious Disease Institute, Massachusetts Eye & Ear, Harvard Medical School, Boston, MA.

Eden E L Tanner (EEL)

John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA.

Samir Mitragotri (S)

John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA.

Rafaella N E Silva (RN)

The Boston Keratoprosthesis Laboratory, Department of Ophthalmology, Massachusetts Eye & Ear, Boston, MA.
Harvard Medical School, Boston, MA.

Ilene Gipson (I)

Harvard Medical School, Boston, MA.
Schepens Eye Research Institute, Massachusetts Eye & Ear, Harvard Medical School, Boston, MA.

James Chodosh (J)

The Boston Keratoprosthesis Laboratory, Department of Ophthalmology, Massachusetts Eye & Ear, Boston, MA.
Harvard Medical School, Boston, MA.
Infectious Disease Institute, Massachusetts Eye & Ear, Harvard Medical School, Boston, MA.

Irmgard Behlau (I)

Molecular Biology and Microbiology and Ophthalmology, Tufts Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA; and.
Infectious Diseases, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA.

Eleftherios I Paschalis (EI)

The Boston Keratoprosthesis Laboratory, Department of Ophthalmology, Massachusetts Eye & Ear, Boston, MA.
Harvard Medical School, Boston, MA.

Michael S Gilmore (MS)

Harvard Medical School, Boston, MA.
Infectious Disease Institute, Massachusetts Eye & Ear, Harvard Medical School, Boston, MA.

Claes H Dohlman (CH)

The Boston Keratoprosthesis Laboratory, Department of Ophthalmology, Massachusetts Eye & Ear, Boston, MA.
Harvard Medical School, Boston, MA.

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