Voriconazole eye drop formulation may be effective for treating fungal keratitis

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Study: Voriconazole eye drop formulation may be effective for

treating fungal keratitis

OSN SuperSite - Thorofare,NJ*

http://www.osnsupersite.com/view.asp?rID=27241

A formulation of voriconazole eye drops appears effective, well-

tolerated and capable of reaching adequate aqueous humor levels for

treating refractory fungal keratitis, according to a prospective

study by researchers in Australia, published in the March issue of

Archives of Ophthalmology.

" This preparation is likely to have a valuable role in the

therapeutic management of Candida and Aspergillus keratitis. It is

substantially more affordable than oral therapy and has less

potential to cause systemic adverse effects, " the authors said.

Mervyn Ferdinands, MBBS(Hons), and colleagues randomly assigned 10

patients with refractory fungal keratitis to receive a 1% solution

of Vfend (voriconazole, Pfizer) in one of two dosing regimens before

performing routine anterior segment surgery.

Specifically, the researchers administered a 1% solution of

voriconazole, preserved with 0.01% benzalkonium chloride, to five

patients every 6 hours for 3 days and to five patients in 4 hourly

preoperative doses.

During the anterior segment procedure, the surgeons used a 30-gauge

needle attached to a syringe to aspirate 0.1 mL to 0.2 mL of aqueous

humor through a paracentesis site before infusing irrigation

solution. Aqueous humor samples were then refrigerated at 4°C, and

the researchers used validated high-performance liquid

chromatography to determine voriconazole levels.

The mean voriconazole concentration after hourly dosing before

surgery was 1.9 µg/mL. The mean voriconazole concentration after a

single dosing preoperatively every 6 hours was 0.94 µg/mL.

The mean sampling times after the last administration of eye drops

were 1.1 hours after hourly dosing and 2.1 hours after a single

dosing every 6 hours, according to the study.

The surgeons administered a total of 80 eye drops, with each patient

receiving between 2 mg and 6 mg, or " about 1% to 3% of the usual

daily oral dose, " the authors noted.

" Five participants reported no adverse reaction, three reported one

instance of stinging, one reported two instances of stinging, and

one reported sneezing and coughing after the initial dose, " they

added.