الكاتب: Multiple References

Itraconazole (Janssen Pharmaceutica, Beerse, Belgium: R51211) is a new, highly lipophilic third generation triazole imidazole antifungal compound. As with other azoles, itraconazole appears to affect the demethylation of lanosterol and its analogues in the biosynthesis of cell-membrane ergosterol. Itraconazole is thought to have more activity than the other azole compounds (miconazole, ketoconazole, fluconazole) against Aspergillus species (Remmel et al., 1988; Schmitt et al., 1992). Itraconazole also was demonstrated to possess a broad spectrum of antifungal activity (Van Cutsem et al., 1987). Fungal keratitis was first described in humans in 1879 (Leber, 1879) and appears to have a higher incidence in the horse compared to other species (Peiffer, 1979; Kern et al., 1983, Samuelson et al., 1984; Barton, 1992). Horses are the only domestic animals that have a high incidence of spontaneous fungal keratitis and therefore provide the only natural animal model for comparative ophthalmic study. Due to a paucity of commercially formulated ophthalmic antifungal medications, most topical medications used for treatment of mycotic keratitis in humans and horses are custom formulated from parenteral antifungal medication. We hoped that if itraconazole could be formulated to achieve therapeutic corneal concentrations following topical application, it might become a treatment option for fungal keratitis in horses that would be economical and improve cure rates. This also may lead to a new viable treatment modality in people.