Acanthamoeba keratitis. Potential role for topical clotrimazole in combination chemotherapy
W. T. Driebe Jr, G. A. Stern, R. J. Epstein, G. S. Visvesvara, M. Adi and T. Komadina
Department of Ophthalmology, University of Florida College of Medicine, Gainesville 32610-0284.
Clotrimazole is an antifungal agent that has been shown to have excellent
in vitro activity against most strains of Acanthamoeba. We encountered four
patients who developed Acanthamoeba keratitis while wearing contact lenses
that had been stored in homemade saline. Their medical treatment regimens
included the use of topical 1% clotrimazole. In two patients in whom
conventional therapy failed, clotrimazole was successful in controlling
recurrent infection following penetrating keratoplasty. Two other patients
were treated with clotrimazole as well as propamidine isethionate and
neomycin sulfate-polymyxin B sulfate-gramicidin from the outset, and had an
excellent response to medical therapy. In those patients who found the
commercially available cream uncomfortable, a 1% clotrimazole suspension
formulated in artificial tears was used and found to be well tolerated.
