Chlorhexidine gluconate 0.2% as a treatment for recalcitrant fungal keratitis in Uganda: a pilot study

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dc.contributor.authorArunga, Simon
dc.contributor.authorMbarak, Tumu
dc.contributor.authorEbong, Abel
dc.contributor.authorMwesigye, James
dc.contributor.authorKuguminkiriza, Dan
dc.contributor.authorMohamed-Ahmed, Abeer H. A.
dc.contributor.authorJohn Hoffman, Jeremy
dc.contributor.authorLeck, Astrid
dc.contributor.authorHu, Victor
dc.contributor.authorBurton, Matthew
dc.date.accessioned2023-03-18T16:42:44Z
dc.date.available2023-03-18T16:42:44Z
dc.date.issued2021
dc.description.abstractFungal keratitis is a major ophthalmic public health problem, particularly in low-income and middle-income countries. The options for treating fungal keratitis are limited. Our study aimed to describe the outcomes of using chlorhexidine 0.2% eye-drops as additional treatment in the management of patients with recalcitrant fungal keratitis. Methods This study was nested within a large cohort study of people presenting with microbial keratitis in Uganda. We enrolled patients with recalcitrant fungal keratitis not improving with topical natamycin 5% and commenced chlorhexidine 0.2%. Follow-up was scheduled for 3 months and 1 year. The main outcome measures were healing, visual acuity and scar size at final follow-up. Results Thirteen patients were followed in this substudy. The patients were aged 27–73 years (median 43 years). Filamentous fungi were identified by microscopy of corneal scrape samples in all cases. Isolated organisms included Aspergillus spp, Fusarium spp, Candida spp, Bipolaris spp and Acremoninum spp. At the final follow-up, nine patients (75%) had healed; three had vision of better than 6/18. Three patients lost their eyes due to infection. In the remaining nine cases, corneal scarring was variable ranging from 4.6 to 9.4 mm (median 6.6 mm, IQR 5.9–8.0 mm); of these five had dense scars, three had moderate scars and one had a mild scar. None of the patients demonstrated signs of chlorhexidine toxicity during the follow-up. Conclusion Chlorhexidine 0.2% was found to be a useful sequential adjunctive topical antifungal in cases of fungal keratitis not responding to natamycin 5%, which warrants further evaluation.en_US
dc.identifier.citationArunga S, Mbarak T, Ebong A, et al. Chlorhexidine gluconate 0.2% as a treatment for recalcitrant fungal keratitis in Uganda: a pilot study. BMJ Open Ophthalmology 2021;6:e000698. doi:10.1136/ bmjophth-2020-000698en_US
dc.identifier.other10.1136/ bmjophth-2020-000698
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/8237
dc.language.isoenen_US
dc.publisherBMJ open ophthalmologyen_US
dc.subjectChlorhexidine gluconateen_US
dc.subjectTreatmenten_US
dc.subjectRecalcitrant fungal keratitisen_US
dc.subjectPilot studyen_US
dc.titleChlorhexidine gluconate 0.2% as a treatment for recalcitrant fungal keratitis in Uganda: a pilot studyen_US
dc.typeArticleen_US
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