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2003 OMIG, Abstract 14

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Will Voriconazole Become the Antifungal of Choice In the treatment of Corneal Yeast Infection?
M. Shah, D. Ritterband, M. Rhee, T. Kaiura, W. Perez, R. Koplin. J. Seedor. The New York Eye and Ear Infirmary, New York, New York, and New York Medical College, Valhalla, New York.

Purpose: To determine the in vitro susceptibilities of ocular yeast isolates to amphotericin B and voriconazole, a new antifungal agent approved for systemic use.
Methods: 25 Candida species isolated from corneal infection or corneal rim culture archived at the New York Eye and Ear Infirmary were tested using E-test strips of amphotericin B and voriconazole to determine the MIC. 17 C.albicans, 6 C.parapsilosis, one C.glabrata, and one C.zeylanoides were tested. The Candida species were incubated for 24 hours on Sabouraud dextrose agar (BBL). A 0.5 McFarland turbidity was achieved in 0.85% NaCI. A sterile swab was dipped in the inoculum suspension and any excess fluid pressed out. The inoculum was carefully swabbed on Mueller-Hinton agar (BBL) in 3 directions to achieve even growth. The media absorbed any additional moisture for 15 minutes before E-test placement. Culture plates were then placed in a plastic bag to control incubator moisture and incubated at 35oC for 24 to 48 hours. The MIC was read at the point where the inhibition ellipse intersected the scale on the strip.
Results: MICs were lower for voriconazole in 14 of 17 C.albicans species, 5 of 6 C.parapsilosis species, and for the one species of C.glabrata and C.zeylanoides compared to amphotericin B.
Conclusions: Our study suggests that voriconazole, a second generation triazole, has in vitro effectiveness against ocular yeast isolates. The potential clinical effectiveness of voriconazole awaits further investigation.


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