Topical caspofungin 0.5% for the treatment of experimental Candida albicans keratitis

1. Zafer Cetinkaya¹
2. Sıtkı Samet Ermis²

¹Department of Microbiology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey.
²Department of Ophthalmology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey.

Purpose: The treatment of fungal keratitis is difficult and remains unresolved since the unavailability of the effective antifungal agents. The aim of this study was to compare the antifungal efficacy of topically applied caspofungin in experimentally induced Candida albicans keratitis in rabbits.

Methods: Eighteen rabbits were randomly and equally divided into three groups. Seventy-two hours after intracorneal injection of Candida albicans (2,5 x 106 /0.1ml CFU), group 1 was treated with topical caspofungin 0.5%, group 2 treated topical amphotericin B 0.15% and group 2 was used as control. Eye drops were administered hourly between 08:00 to 22:00 at days 1 and 2; four times daily for 3 continuous days. The extent of keratitis was graded by an observer by scoring conjunctival hyperemia, corneal clouding, diameter of corneal infiltration, corneal neovascularisation and hypopyon level.

Results: In rabbits treated by topical caspofungin 0.5% and topical amphotericin B 0.15% progression of keratitis was inhibited and the clinical scores were significantly lower than the control group (p < 0.05). In our rabbit model, 0.5% caspofungin was as effective as 0.15% AMB for the topical treatment of Candida keratitis. On day 5 the mean CFU was 5 x 104 in control group while no Candida albicans was recovered by culture from treatment group.

Conclusion: Topical caspofungin 0.5% is effective in treating Candida albicans keratitis without any evident side effect.