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Evaluation of Liposomal and Conventional Amphotericin B in Experimental Fungal Keratitis Rabbit Model

Anup Kumar Ghosh1, Shivaprakash Mandya Rudramurthy1, Amit Gupta2

  • 1Department of Medical Microbiology, PGIMER, Chandigarh, India.

Translational Vision Science & Technology
|June 18, 2019
PubMed
Abstract

Insights

Liposomal amphotericin (Fungisome) showed clinical improvement for fungal keratitis (FK) in rabbits compared to controls. However, Fungisome and conventional amphotericin (AMB) demonstrated similar efficacy in this FK rabbit model.

Area of Science:

  • Ophthalmology
  • Mycology
  • Pharmacology

Background:

  • Fungal keratitis (FK) is a significant cause of corneal blindness, particularly in developing nations.
  • Treatment outcomes for FK are often inconsistent due to a lack of standardized regimens.
  • Liposomal amphotericin B (AMB) has established efficacy in systemic fungal infections, but its topical application for FK requires further investigation.

Purpose of the Study:

  • To compare the efficacy of topical liposomal amphotericin (Fungisome) against conventional amphotericin B (AMB) for treating experimental fungal keratitis (FK) in rabbits.
  • To evaluate the efficacy of two different concentrations of Fungisome (0.1% and 0.05%) and one concentration of AMB (0.1%) in a rabbit FK model.

Main Methods:

  • Experimental FK was induced in 48 rabbits using *Aspergillus flavus* or *Candida albicans*.
  • Rabbits were randomized into four groups: 0.1% Fungisome, 0.05% Fungisome, 0.1% AMB, and an untreated control group.
  • Clinical scores were assessed throughout the study, and fungal burden was quantified by corneal button culture at the study endpoint (day 19).

Main Results:

  • Both 0.1% and 0.05% Fungisome significantly improved clinical scores compared to controls in the *A. flavus* model by day 11.
  • In the *C. albicans* model, 0.1% Fungisome showed significant improvement by day 9 compared to controls.
  • The lowest fungal burden in both models was observed in the 0.1% Fungisome-treated group, although no statistically significant differences in clinical outcomes were found between Fungisome and AMB treatments.

Conclusions:

  • Topical Fungisome demonstrated clinical efficacy in treating experimental fungal keratitis in rabbits.
  • No statistically significant differences in treatment outcomes were observed between liposomal amphotericin (Fungisome) and conventional amphotericin B (AMB).
  • Further clinical studies in humans are warranted to confirm these findings and establish optimal treatment protocols for FK.
Keywords:
Aspergillus flavusCandida albicansamphotericin bkeratitisliposomal amphotericin brabbit model

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