Which topical antifungal is used for fungal keratitis?

Which topical antifungal is used for fungal keratitis?

• A. Natamycin
• B. Fluconazole
• C. Ketoconazole
• D. Griseofulvin

Answer: (A)

Fungal keratitis is most effectively treated with an antifungal that has strong activity against filamentous fungi that commonly invade the cornea. Natamycin fits this need best because it covers the filamentous pathogens (like Fusarium and Aspergillus) that are frequently responsible for this infection and is used as the first-line topical therapy. Its use as a 5% eyedrop provides reliable surface activity in the infected cornea, making it the preferred choice. Other antifungals listed—fluconazole and ketoconazole—are azoles with less reliable activity against filamentous fungi in the cornea and poorer penetration for this site, while griseofulvin is largely ineffective for ocular infections due to poor corneal penetration and limited spectrum.

Fungal keratitis is most effectively treated with an antifungal that has strong activity against filamentous fungi that commonly invade the cornea. Natamycin fits this need best because it covers the filamentous pathogens (like Fusarium and Aspergillus) that are frequently responsible for this infection and is used as the first-line topical therapy. Its use as a 5% eyedrop provides reliable surface activity in the infected cornea, making it the preferred choice. Other antifungals listed—fluconazole and ketoconazole—are azoles with less reliable activity against filamentous fungi in the cornea and poorer penetration for this site, while griseofulvin is largely ineffective for ocular infections due to poor corneal penetration and limited spectrum.