Natamycin in the treatment of fungal keratitis: A systematic review and Meta-analysis

Sheng Qiu, Gui Qiu Zhao, Jing Lin, Xue Wang, Li Ting Hu, Zhao Dong Du, Qian Wang, Cheng Cheng Zhu

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56 Scopus citations


AIM: To review published clinical studies examining the effect of natamycin in the treatment of fungal keratitis. • METHODS:We selected the publications in CENTRAL, MEDLINE, EMBASE, CNKI, and CBM. This study systematically reviewed published randomized controlled trials (RCTs) that compared natamycin to other antifungal agents, and conducted feasible Meta-analysis of efficacy results using Revman 5.2 software. • RESULTS: We included seven trials which were mainly carried out in developing countries of Asia, with five trials conducted in India, one each in China and Bangladesh. A total of 804 participants were randomized to following comparisons:2% econazole versus 5% natamycin showed little difference in the effects of treatment of fungal keratitis [RR=0.99, 95% confidence interval (CI), 0.8 to 1.21]; chlorhexidine gluconate versus 5% natamycin indicated that the results on healing of the ulcer at 21d was less conclusive (RR=0.77, 95% CI, 0.55 to 1.08; I2=0%); 1% voriconazole versus 5% natamycin suggested that natamycin treatment appeared to be significantly better outcomes than voriconazole (regression coefficient =-0.18 logMAR; 95% CI, -0.30 to -0.05; P=0.006), especially in Fusarium cases (regression coefficient=-0.41 logMAR; 95% CI, -0.61 to -0.20; P<0.001); natamycin versus fluconazole showed a significant difference in cure rate (χ2 =5.048, P<0.05) and natamycin group was more effective than fluconazole in average period of therapy (t=7.94, P<0.01). • CONCLUSION: Natamycin was a preferable choice in the treatment of fungal keratitis, especially in the early period of Fusarium cases.

Original languageEnglish
Pages (from-to)597-602
Number of pages6
JournalInternational Journal of Ophthalmology
Issue number3
StatePublished - 18 Jun 2015
Externally publishedYes


  • Eye infection
  • Fungal
  • Meta-analysis
  • Natamycin


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