Douglas J. Rhee, MD

A. PROTOZOADrug Trade Concentration Dose Notes48(1) AcanthamoebaNote: Give combination of 2–3 different drops Q1/2 hr–2 hr; can consider adding itraconazole 200 mg PO QD-BID or voriconazole200 mg po BID.propamidine isethionate Brolene Soln, 0.1% Q1/2 hr–2 hr First line agent; not available commerciallyin the US; available over the counter inthe UK; can be obtained fromcompounding pharmacies; active againsttrophozoites.polymyxin B /neomycin / AK-Spore , Neosporin, Soln, 10,000 u/ Q1/2 hr–2 hr Second line agent; significant surface toxicitygramicidin Ocuspor G , 0.35%/0.025%Polymycinpolyhexamethylene Baquacil Soln, 0.02% Q1/2 hr–2 hr First line agent; not available commercially inbiguanide (PHMB) the US; can be obtained from compoundingpharmacies; active against cysts andtrophozoiteschlorhexidine Soln, 0.02% Q1/2 hr–2 hr First line agent; not available commerciallyinthe US; can be obtained from compoundingpharmacies; active against cysts andtrophozoitesclotrimazole Susp, 1% Q1–2 hr Second line agentdibromopropamidine Brolene Oint, 0.15% QHS To be used during taper of Brolene drops; notisethionate available commercially in USitraconaxole Sporanox 200 mg PO BIDvoriconazole Vfend 200 mg PO BID