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Updated: Apr 17, 2026

Author Spotlight: Studying Behavior of Acanthamoeba to Develop Targeted Strategies for Preventing Acanthamoeba Keratitis
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Medical interventions for acanthamoeba keratitis.

Majed Alkharashi1, Kristina Lindsley, Hua Andrew Law

  • 1Department of Ophthalmology, King Saud University, Riyadh, Saudi Arabia. majedsk@hotmail.com.

The Cochrane Database of Systematic Reviews
|February 25, 2015
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Summary

Limited evidence suggests no significant difference between chlorhexidine and polyhexamethylene biguanide for Acanthamoeba keratitis (AK) treatment. More research is needed due to small sample sizes in current studies on this serious eye infection.

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Area of Science:

  • Ophthalmology
  • Microbiology
  • Infectious Diseases

Background:

  • Acanthamoeba are single-celled organisms that can cause Acanthamoeba keratitis (AK), a severe eye infection.
  • AK can lead to vision loss or even the loss of the eye.
  • Current treatment guidelines for AK are lacking.

Purpose of the Study:

  • To assess the effectiveness and safety of medical treatments for Acanthamoeba keratitis (AK).

Main Methods:

  • Conducted a comprehensive literature search across multiple databases for randomized controlled trials (RCTs) on AK medical therapy.
  • Included RCTs comparing anti-amoeba therapies or comparing them to no treatment.
  • Two independent reviewers screened studies, assessed bias, and extracted data.

Main Results:

  • One RCT involving 56 eyes compared topical chlorhexidine 0.02% with polyhexamethylene biguanide (PHMB) 0.02% for AK treatment.
  • Resolution of infection occurred in 86% of chlorhexidine-treated eyes versus 78% of PHMB-treated eyes (RR 1.10, 95% CI 0.84 to 1.42).
  • Visual acuity improvement and need for keratoplasty showed no significant differences between groups; no drug toxicity was reported.

Conclusions:

  • Insufficient evidence exists to determine the relative effectiveness and safety of medical therapies for AK.
  • The single included study found no significant difference between chlorhexidine and PHMB.
  • The study's small sample size limits the ability to detect clinically meaningful differences.