Antifungal Efficacy and Safety of Cycloheximide as a Supplement in Optisol-GS

Drug Des Devel Ther. 2021 May 18:15:2091-2098. doi: 10.2147/DDDT.S298059. eCollection 2021.

Abstract

Purpose: The incidence of fungal infection after corneal transplant has increased significantly in recent years, especially Candida spp. This study aimed to evaluate the efficacy and safety of the addition of cycloheximide in Optisol-GS media in decreasing the growth of Candida spp. strains.

Methods: This in vitro laboratory efficacy study measured fungal colony growth in 24 vials of Optisol-GS that were divided into 6 groups of 4 vials each, as follows: (1) MIC/2 cycloheximide, (2) MIC cycloheximide, (3) MICx5 cycloheximide, (4) MICx10 cycloheximide, from MIC values obtained for each strain, (5) unsupplemented optisol-GS as a positive control (added inoculum), and (6) unsupplemented optisol-GS as a negative control (no inoculum). In each group was added Candida albicans, C. glabrata and C. parapsilosis, except in the negative control. The evaluated variables were fungal colony growth from the Optisol-GS vials, corneal endothelial cell density and endothelial cell viability at different concentrations of cycloheximide.

Results: In the efficacy study, all strains showed a reduction in fungal cell growth from the second day at all evaluated concentrations of optisol-GS supplemented with cycloheximide, even at subinhibitory concentrations (MIC/2). For C. glabrata, the colony count was reduced to 99%. No evidence of corneal endothelial toxicity was found at any concentration, in the safety study, compared with the paired control.

Conclusion: The addition of cycloheximide to optisol-GS decreased the fungal growth, demonstrating fungicide action against C. glabrata and fungistatic action against C. albicans and C. parapsilosis. This drug did not demonstrate toxicity to the corneal endothelium at different concentrations.

Keywords: cornea; eye banking; infection; pharmacology.

MeSH terms

  • Antifungal Agents / pharmacology*
  • Candida / drug effects*
  • Candida / growth & development
  • Chondroitin Sulfates / pharmacology*
  • Complex Mixtures / pharmacology
  • Cycloheximide / pharmacology*
  • Dextrans / pharmacology*
  • Gentamicins / pharmacology*
  • Microbial Sensitivity Tests

Substances

  • Antifungal Agents
  • Complex Mixtures
  • Dextrans
  • Gentamicins
  • Chondroitin Sulfates
  • Optisol
  • Cycloheximide