Page 1 of 1: ophthal: ancanthaameba keratitis

guddy · Credits: 5770 My Scrapbook

a patient using contact lens develops corneal infection diagnosis acanthameba keratitis made best treatment
a propamide
b neosporin
c ketoconazole
d polyhexamethylene

devt · Credits: 10994 My Scrapbook

Amongst choices a is best.

parin · Credits: 14470 My Scrapbook My Reading List 1 Books

Polyhexamethylene biguanide (PHMB) is the drug of choice for acanthamoeba keratitis.. propamidine is second choice..

hence answer should be D..

parin · Credits: 14470 My Scrapbook My Reading List 1 Books

Polyhexamethylene biguanide (PHMB) is the drug of choice for acanthamoeba keratitis.. propamidine is second choice..

hence answer should be D..

devt · Credits: 10994 My Scrapbook

Does not say biguanide in d choice. Surely, if we presume it then acceptable.

parin · Credits: 14470 My Scrapbook My Reading List 1 Books

You can see an article in cornea journal website..

cysts & trophozoites of acanthamoeba were immeresed in 5 separate solutions - 0.1% PHMB, 0.02% PHMB, 0.1% chlorhexidine, 0.02% chlorhexidine & propamidine isethionate..

The purpose was to assess efficacy of these 3 drugs in different concentrations against different strains of acanthamoeba using reculture technique..

Result was: Chlorhexidine (0.1% & 0.02%) was the only drug that was effective against all the 5 strains if acanthamoeba & no trophozoites were detected, 0.1% chlorhexidine was the only drug that was effective in eradicating cysts..

Conclusion was: it may be possible that 0.02% chlorhexidine is a good initial treatment in amoebic keratitis..

Regarding this question, I'd say yes, we have to assume it to be PHMB.. that is the problem.. but propamidine is also propamidine isethionate!! though it is also popular as "propamidine" only too.. I'd go for D.. otherwise choice is personal!!

drsmita_s · Credits: 18609 My Scrapbook

dear parin, what is the reference? i cudn't find anything in kdt and harri mentions only propamidine.

parin · Credits: 14470 My Scrapbook My Reading List 1 Books

dear smita,

I'm quite surprised to see Harrison's mentioning only one drug with "partial responses"!!

however, my reference was Current Diagnosis & Treatment of Tropical Infections..

drtr · Credits: 846 My Scrapbook

All the four can be used as specific treatment along with the generl lines of management of corneal ulcer.

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