RESUMO
Objetivo:
Avaliar a eficácia do uso do fluconazol subconjuntival em ceratite fúngica por Fusarium solani experimentalmente induzida em modelo animal.
Métodos:
Após imunossupressão prévia com corticosteróide subconjuntival, o inóculo padrão, preparado com o auxílio do método de espectrofotometria, foi injetado no estroma corneano. Depois de três dias, iniciou-se a aplicação de 300 μl de fluconazol subconjuntival (grupo 1) ou placebo (grupo 2), por quatro dias consecutivos. Cinco dias após a primeira dose subconjuntival de fluconazol ou placebo, procedeu-se ao sacrifício dos animais e à trepanação das córneas e imersão destas em meio de enriquecimento líquido. Alíqüotas de 100, 10 e 1 μl deste meio foram semeadas, após 3 dias, em placas com Sabouraud-dextrose e as colônias crescidas, contadas em 5 dias.
Resultados:
A análise estatística considerou o número de colônias crescidas nas diferentes diluições, para cada grupo. Não houve diferença estatisticamente significante entre o grupo tratado com fluconazol subconjuntival e o grupo controle.
Conclusão:
A utilização de fluconazol subconjuntival, durante 4 dias, não foi eficaz na redução do número de colônias crescidas em placas, quando comparado com o grupo tratado apenas com placebo, em ceratite fúngica por Fusarium solani experimentalmente induzida em coelhos.
Palavras-chave:
Fluconazol; Micose; Ceratite; Fungo; Fusarium
SUMMARY
Purpose:
To assess whether subconjunctivally injected fluconazole was effective in experimental Fusarium solani keratomycosis in rabbits.
Methods:
After corticosteroid immuno supression of the rabbit eyes, 20 μ1 of the inoculum, prepared by the spectrophotometric method, were injected into the midcorneal stroma. Three days later, either 300 μ1 subconjuntival fluconazole or placebo injections were initiated and given during four consecutive days. After five days of the first dose, the animals were sacrified and the corneas trephined and immersed in appropriate liquid growth media. Aliquots of 100, 10 and 1 μl were placed in ágar-Sabouraud-dextrose medium plates and the growth of F. solani determined by counting the number of colonies grown in the plates after 5 days.
Results:
Statistical analysis considered the number of colonies in the different dillutions, for each group. There was no statistical significant difference between the fluconazole-treated group and the placebo group.
Conclusion:
The present investigation did not find any significant reduction in the number offungal colonies grown in plates, after administration ofsubconjunctival fluconazole during 4 consecutive days, when compared to the placebo-treated group, in cases of experimentally induced F. solani keratitis in rabbits.
Keywords:
Fluconazole; Mycosis; Keratitis; Fungus; Fusarium
Texto completo disponível apenas em PDF.
-
Apresentado como tema-livre durante o XXIX Congresso Brasileiro de Oftalmologia.
-
Trabalho realizado com apoio financeiro do CAPES.
REFERÊNCIAS BIBLIOGRÁFICAS
-
1Thomas PA. Mycotic keratitis: an underestimated mycosis. J Med Vet Mycol 1994;32:235-56.
-
2Abad JC, Foster CS. Fungal keratitis. Intern Ophthalmol Clin 1996;36(3):1-15.
-
3Lima ALH, Nishi M, Lottenberg CL, Guidugli T. Úlceras de córnea em serviço de referência. Arq Bras Oftalmol 1988;51:118-20.
-
4Vieira LA, Carneiro MDF, Guidugli T, Scarpi M. Incidência de úlceras corneanas fúngicas no laboratório de doenças externas oculares da Escola Paulista de Medicina. Arq Bras Oftalmol 1992;55(4):180.
-
5Lima ALH, Belfort Jr R, Parel JM, Rebell G. Penetração de diferentes antimicóticos na córnea humana: estudo "in vitro ". Arq Bras Oftalmol 1987;50(2):80-7.
-
6Gonçalves JOR. A irrigação contínua no tratamento das úlceras micóticas da córnea. Arq Bras Oftalmol 1977;40:232-35.
-
7Ishibashi Y. Experimental fungai keratitis due to Fusarium: studies on animal model and innoculation technique. In: Schimiza K, Oosterhuis J. Proceedings of the XXIII Concilium Ophthalmologicum of Kyoto. Amsterdam, Excerpta Medica 1978;1705-8.
-
8National Committee for Clinical Laboratory Standards (NCCLS). Reference method for broth dilution antifungal susceptibility testing of yeasts: tentative standard. Villanova, NCCLS 1995;15(10):29p,M27-P.
-
9Espinel-Ingroff A, Bartlett M, Bowden R, Chin NX, Cooper Jr C, Fothergill A, Mcginnis MR, Menezes P, Messer SA, Nelson PW, Odds FC, Pasarell L, Peter J, Pfaller MA, Rex JH, Rinaldi MG, Shankland GS, Walsh TJ, Weitzman I. Multicenter evaluation of proposed standardized procedure for antifungal susceptibility testing of filamentous fungi. J Clin Microbiol 1997;35(1): 139-43.
-
10Colombo AL, McGough DA, Rinaldi MG. Discrepancies between MIC and MLC values of amphotericin B against isolates of Aspergillus species Mycopathologica 1994;128:129-33.
-
11Klippenstein K, O'Day DM, Robinson RD, Williams TE, Head WS. The qualitative evaluation of the phannacokinetics of subconjunctivally injected antifungal agents in rabbits. Cornea 1993;12(6):512-6.
-
12Yee RW, Cheng CJ, Meenakshi S, Ludden TM, Wallace JE, Rinaldi MG. Ocular penetration and pharmacokinetics of topical fluconazole. Cornea 1997; 16(1):64-71.
-
13Behrens-Baumann W, Klinge B, Rüchel R. Topical fluconazole for Candida keratitis in rabbits. Br J Ophthalmol 1990;74:40-2.
-
14Sekhon AS, Padhye AA, Garg AK, Ahmad H; Moledina N. "In vitro" sensitivity of medically significant Fusarium species to various antimycotics. Chemotherapy 1994;40:239-44.
-
15Speeleveld E, Gordts B, Van Landuyt HW, De Vroey C, Raes-Wuytack C. Susceptibility of clinical isolates of Fusarium to antifungal drugs. Mycoses 1996;39:37-40.
-
16Pujol I, Guarro J, Gené J, Sala J. "In vitro" antifungal susceptibility of clinical and enviromental Fusarium spp strains. J Antimicrob Chemother 1997;39:163-7.
-
17Grant SM, Clissold SP. Fluconazole: a review of its phannacodynamic and pharmacokinetic properties, and therapeutic potencial in superficial and systemic mycoses. Drugs 1990;39(6):877-916.
-
18Espinel-lngroff A, Dawson K, Pfaller M, Anaissie E, Breslin B, Dixon D, Fothergill A, Peter J, Rinaldi M, Walsh T. Comparative and collaborative evaluation of standardization of antifungal susceptibility testing for filamentous fungi. Antimicrob Agents Chemother 1995;39:314-9.
-
19Pfaller MA, Rinaldi MG. Antifungal susceptibility testing: current state of technology, limitations and standardization. Infec Dis Clin Nort Am 1993;7(2): 435-44.
-
20Reuben A, Anaissie E, Nelson PE, Hashem R, Legrand C, HO DH. Antifungal susceptibility of 44 clinical isolates of Fusarium species detennined by using a broth microdilution method. Antimicrob Agents Chemother 1989;33:1647-9.
-
21Kiryu H, Yoshida S, Suenaga Y, Asahi M. Invasion and survival of Fusarium solani in the dexamethasone-treated cornea of rabbits. J Med Vet Mycol 1991;29:395-406.
-
22Brummer E, Stevens DA. Synergy of human neutrophils with fluconazole in killing Candida species. Mycopathologia 1996;134:115-20.
-
23Rheins MS, Suie T, Van Winkle MG, Havener WH. Potentiation of mycotic ocular infections by drugs. Br J Ophthalmol 1966;50:533-9.
Datas de Publicação
-
Publicação nesta coleção
Oct 1998