Topical Therapies for Keratomycosis

Drug

Concentration

Frequency

Notes

Fluconazole

0.2% solution

q 2–6 h

Subconjunctival and intravitreal injections have been described

Itraconazole

1% ointment/30% DMSO

q 2–6 h

Does not penetrate anterior chamber

Miconazole

1% solution

q 2–6 h

Subconjunctival and intracameral injections have also been described

Voriconazole

1% solution

q 2–6 h

Penetrates intact corneal epithelium

Amphotericin B

0.075%–5% solution

q 2–6 h

Subconjunctival, intravitreal, and intracameral injections after proper dilution have also been described

Natamycin

5% suspension

q 2–6 h

Only FDA-approved drug for fungal keratitis (humans); does not penetrate intact corneal epithelium

Terbinafine

1% ointment

q 2–6 h

Not suitable for deep corneal or intraocular mycoses

Silver Sulfadiazine

1% ointment/cream

q 6–24 h