Abstract:
Acanthamoeba spp. are pathogens that cause Acanthamoeba keratitis (AK), a serious cornea inflammation that can lead to gradual loss of vision, permanent blindness, and keratoplasty. The efficacy of AK treatment depends on the drug\'s ability to reach the target tissue by escaping the protective eye barrier. No single drug can eradicate the living forms of the amoeba and be non-toxic to the cornea tissue. The treatment aims to eradicate both forms of protozoan life but is hampered by the resistance of the cysts to the most available drugs, leading to prolonged infection and relapses. Drug therapy is currently performed mainly using diamidines and biguanides, as they are more effective against cysts. However, they are cytotoxic to corneal cells. Drugs are applied topically, and hourly. Over time, the frequency of administration decreases, but the treatment time varies from month to years. This study aims to obtain an up-to-date summary of the literature since 2010, allowing us to identify the trends and gaps and address future research involving new alternatives for treating AK. The results were divided into three phases, pre-treatment, empirical treatment, and the treatment after diagnosis confirmation. The drugs prescribed were stratified into antiamoebic, antibiotic, antifungal, antivirals, and steroids. It was possible to observe the transition in drug prescription during three different stages until the diagnosis was confirmed. There were more indications for antibiotic, antifungal, and antiviral drugs in the early stages of the disease. The antiamoebic drugs were only prescribed after exhausting other treatments. This can be directly involved in developing complications and no responsiveness to medical treatment.
摘要:
棘阿米巴。是导致棘阿米巴角膜炎(AK)的病原体,严重的角膜炎症会导致视力逐渐丧失,永久性失明,和角膜移植术.AK治疗的疗效取决于药物通过逃避保护眼屏障到达靶组织的能力。没有一种药物可以根除阿米巴的生物形式并且对角膜组织无毒。该治疗旨在根除两种形式的原生动物生命,但由于囊肿对最可用药物的耐药性而受到阻碍,导致长期感染和复发。目前主要使用二胺和双胍进行药物治疗,因为它们对囊肿更有效。然而,它们对角膜细胞有细胞毒性。药物是局部应用的,和每小时。随着时间的推移,给药频率降低,但是治疗时间从月到年不等。本研究旨在获得自2010年以来的最新文献摘要,使我们能够确定趋势和差距,并解决涉及治疗AK的新替代品的未来研究。结果分为三个阶段,预处理,经验处理,以及确诊后的治疗。处方的药物被分层为抗阿米巴,抗生素,抗真菌药,抗病毒药物,和类固醇。可以在三个不同阶段观察药物处方的转变,直到确认诊断。有更多的抗生素适应症,抗真菌药,和抗病毒药物在疾病的早期阶段。抗阿米巴药物仅在用尽其他治疗方法后才处方。这可能直接参与发展并发症和对药物治疗没有反应。