Natamycin in the treatment of fungal keratitis: a systematic review and Meta-analysis

作者：Qiu, Sheng; Zhao, Gui-Qiu^*; Lin, Jing; Wang, Xue; Hu, Li-Ting; Du, Zhao-Dong; Wang, Qian; Zhu, Cheng-Cheng

来源：International Journal of Ophthalmology, 2015, 8(3): 597-602.

DOI：10.3980/j.issn.2222-3959.2015.03.29

• eye infection
• fungal
• natamycin
• Meta-analysis

AIM: To review published clinical studies examining the effect of natamycin in the treatment of fungal keratitis. @@@ METHODS: We selected the publications in CENTRAL, MEDLINE, EMBASE, CNKI, and CBM. This study systematically reviewed published randomized controlled trials (RCTs) that compared natamycin to other antifungal agents, and conducted feasible Meta-analysis of efficacy results using Revman 5.2 software. @@@ RESULTS: We included seven trials which were mainly carried out in developing countries of Asia, with five trials conducted in India, one each in China and Bangladesh. A total of 804 participants were randomized to following comparisons: 2% econazole versus 5% natamycin showed little difference in the effects of treatment of fungal keratitis [RR=0.99, 95% confidence interval (Cl), 0.8 to 1.211; chlorhexidine gluconate versus 5% natamycin indicated that the results on healing of the ulcer at 21d was less conclusive (RR=0.77, 95% Cl, 0.55 to 1.08; I-2=0%); 1% voriconazole versus 5% natamycin suggested that natamycin treatment appeared to be significantly better outcomes than voriconazole (regression coefficient =-0.18 logMAR; 95% Cl, -0.30 to -0.05; P=0.006), especially in Fusarium cases (regression coefficient=-0.41 logMAR; 95% Cl, -0.61 to -0.20; P<0.001); natamycin versus fluconazole showed a significant difference in cure rate (chi(2)=5.048, P<0.05) and natamycin group was more effective than fluconazole in average period of therapy (t=7.94, P<0.01). @@@ CONCLUSION: Natamycin was a preferable choice in the treatment of fungal keratitis, especially in the early period of Fusarium cases.

• 出版日期2015-6-18
• 单位青岛大学