º¸¸®ÄÚ³ªÁ¹ Á¡¾ÈÀÌ ¹è¾ç ¾ç¼º Áø±Õ°¢¸·¿° Ä¡·á¿¡ ¹ÌÄ¡´Â ÀÓ»ó È¿°úÀÇ ºÐ¼®
Clinical Efficacy of Topical Voriconazole as Treatment in Culture-Positive Fungal Keratitis
À±Ã¢È£ ( Yoon Chang-Ho ) - ¼¿ï´ëÇб³ Àǰú´ëÇÐ ¾È°úÇб³½Ç
±è¹Ì±Ý ( Kim Mee-Kum ) - ¼¿ï´ëÇб³ Àǰú´ëÇÐ ¾È°úÇб³½Ç
À§¿ø·® ( Wee Won-Ryang ) - ¼¿ï´ëÇб³ Àǰú´ëÇÐ ¾È°úÇб³½Ç
Abstract
¸ñÀû: º¸¸®ÄÚ³ªÁ¹ Á¡¾ÈÀÌ ¹è¾ç ¾ç¼º Áø±Õ°¢¸·¿°ÀÇ Ä¡·á¿¡ ¹ÌÄ¡´Â ¿µÇâ¿¡ ´ëÇØ¼ ¾Ë¾Æº¸°íÀÚ ÇÏ¿´´Ù.
´ë»ó°ú ¹æ¹ý: 2004³â 10¿ùºÎÅÍ 2010³â 12¿ù±îÁö ¼¿ï´ëÇб³º´¿ø¿¡¼ ¹è¾ç°Ë»ç¾ç¼º Áø±Õ°¢¸·¿°À¸·Î Áø´ÜµÈ 22¸í 22¾ÈÀÇ Àǹ«±â·ÏÀ» ÈÄÇâÀûÀ¸·Î ºÐ¼®ÇÏ¿´´Ù. Á¡¾ÈÄ¡·á ¹æ¹ý¿¡ µû¶ó ¼¼ ±ºÀ¸·Î ³ª´©¾ú°í, º¸¸®ÄÚ³ªÁ¹ ´Üµ¶ »ç¿ë±º(V, n=6), º¸¸®ÄÚ³ªÁ¹°ú ¿¥Æ÷Å׸®½ÅB º´ÇÕ »ç¿ë±º(V+, n=10), ¿¥Æ÷Å׸®½ÅB ´Üµ¶ »ç¿ë±º(A, n=6)À¸·Î ³ª´©¾î ºÐ¼®ÇÏ¿´´Ù.
°á°ú: ¼¼ ±ºÀÇ Ä¡·á¼º°ø·üÀº Â÷À̰¡ ¾ø¾ú´Ù. °üÇØµÈ °æ¿ì V±º¿¡¼ V+±ºº¸´Ù °¢¸·»óÇǰá¼Õ ȸº¹±â°£ÀÌ Âª¾Ò´Ù. Fusarium spp.°¨¿°°ú Àü¹æÃà³óÀº Á¡¾ÈÄ¡·á ½ÇÆÐÀÇ À§ÇèÀÎÀÚ¿´´Ù. 8¾È¿¡¼ »óÇǰá¼Õ ȸº¹ ÈÄ Æò±Õ 66ÀÏ µ¿¾È º¸¸®ÄÚ³ªÁ¹ À¯Áö¿ä¹ýÀ» ½ÃÇàÇß°í °¢¸·»óÇÇÀÇ ¹Ì¶õÀ̳ª °á¼Õ ¼Ò°ßÀº º¸ÀÌÁö ¾Ê¾Ò´Ù.
°á·Ð: º¸¸®ÄÚ³ªÁ¹ Á¡¾ÈÄ¡·á´Â Ç¥ÁØ Ä¡·á¿¡ ºñÇØ Áø±Õ°¢¸·¿° °üÇØ¿¡¼ °¢¸· »óÇÇ °á¼ÕÀÇ È¸º¹ÀÌ ºü¸£°í È¿°ú°¡ ÇÊÀûÇÑ °ÍÀ¸·Î »ý°¢Çϳª Fusarium spp.°¨¿°¿¡ ´ëÇØ¼´Â ´Ù¸¥ Ç¥ÁØÄ¡·á¿Í ¸¶Âù°¡Áö·Î È¿°ú°¡ ¶³¾îÁö¸ç ¼ö¼úÀû Ä¡·á°¡ ÇÊ¿äÇÑ °¡´É¼ºÀÌ ³ô´Ù.
Purpose: To evaluate the efficacy of topical voriconazole in treatment of culture-positive fungal keratitis.
Methods: Twenty-two cases of culture-positive fungal keratitis treated with topical anti-fungal drugs from October 2004 to December 2010 were evaluated and medical records were reviewed. Patients were divided into 3 groups according to the method of topical antifungal treatment; the first group (V, n = 6) received voriconazole monotherapy, the second group (V+, n = 10) received topical voriconazole and amphotericin B combined therapy, and the third group (A, n = 6) received amphotericin B monotherapy.
Results: The treatment success rate between the 3 groups was not significantly different. The epithelial defect healing time of group V was shorter than group V+. Treatment failure risk factors included Fusarium spp. infection and the presence of hypopyon. Eight eyes received topical voriconazole maintenance therapy for 66 days and there were no corneal erosions or epithelial defects.
Conclusion: In fungal keratitis, topical voriconazole is as effective as other standard treatments and provides a faster healing time in the corneal epithelium than other standard treatments. However, voriconazole should be used with caution and therapeutic surgery should be considered in Fusarium spp. infections.
Ű¿öµå
Amphotericin B; Fungal keratitis; Voriconazole
KMID :
0360220120530081068
DOI :
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