Efficacy of antifungal agents in the cornea. II. Influence of corticosteroids.

The influence of topical corticosteroid on the efficacy of five topical antifungal agents was evaluated in a standardized rabbit model of Candida keratitis using a quantitative mycologic technique. Topical 1% prednisolone acetate worsened the disease when given alone and adversely influenced the efficacy of 5% natamycin, 1% flucytosine, and 1% miconazole when given in combination. The efficacy of amphotericin B appeared unaffected when the antifungal agent was administered in concentrations of 0.5% and 0.15%. The adverse effect of the topical corticosteroid appeared to be inversely related to the efficacy of the antifungal agent in vivo.