Combination Treatment of 5% Natamycin and 1% Voriconazole in Fungal Keratitis
Summary
OBJECTIVE To evaluate the efficacy and safety of the concurrent treatment of 5% Natamycin and 1% Voriconazole in patients affected by fungal keratitis METHODS AND MATERIALS STUDY POPULATION Patients with smear and or culture proven fungal keratitis presenting to our Instituts, were eligible for enrollment. STUDY DESIGN Prospective double masked randomized clinical trial.
Timeline
- Start
- 2017-01-01
- Primary completion
- 2018-03-01
- Completion
- 2018-09-30
Outcome
Missed primary endpoint
paper complete healing occurred in 38 of 48 eyes (79.2%) in the combination group and 35 of 46 eyes (76.1%) in the monotherapy group (absolute difference, 3.1%; 95% CI -13.2% to 19.4%; p=0.70). PMID 41365527 ↗
paper Adjunctive topical voriconazole did not significantly improve clinical outcomes compared with natamycin monotherapy. PMID 41365527 ↗
Publications
- Background Sharma S, Das S, Virdi A, Fernandes M, Sahu SK, Kumar Koday N, Ali MH, Garg P, Motukupally SR. Re-appraisal of topical 1% voriconazole and 5% natamycin in the treatment of fungal keratitis in a randomised trial. Br J Ophthalmol. 2015 Sep;99(9):1190-5. doi: 10.1136/bjophthalmol-2014-306485. Epub 2015 Mar 4.
- Results Srinivasan M. Fungal keratitis. Curr Opin Ophthalmol. 2004 Aug;15(4):321-7. doi: 10.1097/00055735-200408000-00008.
- Di Zazzo A, Surico PL, Parmar UPS, Tarini S, De Luca A, Madduri B, Mohan N, Fernandes M. Efficacy of natamycin monotherapy versus combination therapy with voriconazole for fungal keratitis: a randomised clinical trial. Br J Ophthalmol. 2025 Dec 9:bjo-2025-328695. doi: 10.1136/bjo-2025-328695. Online ahead of print.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | Voriconazole | Small molecule | 1 % | Topical |
| Background | Natamycin | Small molecule | 5 % | Topical |