Trial reportJAMA ophthalmology2016
Changing Azole Resistance: A Secondary Analysis of the MUTT I Randomized Clinical Trial.
Trial report in JAMA ophthalmology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00996736 (Mycotic Ulcer Treatment Trial), which is not on this map. Cited by 14 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Mycotic Ulcer Treatment Trial
Who cites it
14 citing papers in PubMed, 23 citations in OpenAlex.
- Morphological Changes in Fungal Elements and Antifungal Drug Susceptibility in an Ex Vivo Model of Fungal Keratitis.Investigative ophthalmology & visual science · 2026Article
- Evaluating Photochemical Interactions Between Rose Bengal Photodynamic Antimicrobial Therapy and Topical Antifungals in Fungal Keratitis Isolates.Investigative ophthalmology & visual science · 2026Article
- Rare fungal keratitis caused by plant pathogens: report of two cases and review of the literature.Frontiers in fungal biology · 2026Review
- First report of Stemphylium lycopersici keratitis, a complex corneal infection case.Journal of ophthalmic inflammation and infection · 2025Article
- Anatomic Biomarkers Predict Poor Presenting Visual Acuity in Infectious Keratitis.Clinical ophthalmology (Auckland, N.Z.) · 2025Article
- Effectiveness of laser pulsed irradiation for antimicrobial photodynamic therapy.Lasers in medical science · 2024Article
- A comparison of antimicrobial regimen outcomes and antibiogram development in microbial keratitis: a prospective cohort study in Alexandria, Egypt.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2024Article
- Eye fungal infections: a mini review.Archives of microbiology · 2023Review
- Evaluation of antifungal susceptibility and clinical characteristics in fungal keratitis in a tertiary care center in North India.Indian journal of ophthalmology · 2022Article
- Diagnosing Fungal Keratitis and Simultaneously IdentifyingJournal of fungi (Basel, Switzerland) · 2022Article
- Infectious keratitis: an update on epidemiology, causative microorganisms, risk factors, and antimicrobial resistance.Eye (London, England) · 2021Review
- Antifungal Efficacy and Safety of Cycloheximide as a Supplement in Optisol-GS.Drug design, development and therapy · 2021Article
- Fungal keratitis: The Aravind experience.Indian journal of ophthalmology · 2017Review
- The persistent dilemma of microbial keratitis: Global burden, diagnosis, and antimicrobial resistance.Survey of ophthalmologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 5 institutions in 2 countries.
Funding
Abstract
importanceThe development of multiple triazole resistance in pathogenic filamentous fungi has become an increasing clinical concern and has been shown to increase the risk for treatment failure.
objectiveTo determine whether antifungal resistance increased during the Mycotic Ulcer Treatment Trial I (MUTT I), as measured by minimum inhibitory concentrations (MICs) in baseline cultures. DESIGN, SETTING, AND
participantsThis secondary analysis of a double-masked, multicenter, randomized clinical trial included patients with culture- or smear-positive filamentous fungal corneal ulcer and a baseline visual acuity of 20/40 to 20/400. Culture-positive samples with susceptibility testing were included in this analysis. The patients were treated at multiple locations of the Aravind Eye Care Hospital system in South India. Data were collected from April 3, 2010, to December 31, 2011, and analyzed from July 15 to September 1, 2015.
interventionsCorneal smears and cultures were obtained from all study participants at baseline. Susceptibility testing was performed for each culture-positive specimen. MAIN OUTCOMES AND MEASURES: Minimum inhibitory concentration of voriconazole and natamycin in baseline cultures.
resultsOf 323 participants with smear-positive specimens (183 men [56.7%]; 140 women [43.3%]; median [interquartile range] age, 47 [38-56] years), fungal-positive cultures were obtained for 256 (79.3%). The MIC data were available for 221 of 323 participants (68.4%), because 35 samples had no growth during susceptibility testing. A 2.14-fold increase per year (95% CI, 1.13-4.56; P = .02) in voriconazole MICs after controlling for the infectious organism was found. This association was not found when looking at natamycin MICs of baseline cultures after controlling for the infectious organism (1.26; 95% CI, 0.13-12.55; P = .85). CONCLUSIONS AND RELEVANCE: Susceptibility to voriconazole appeared to decrease during the relatively short enrollment period of the clinical trial. This decrease may be more related to increased resistance of environmental fungi rather than previous treatment with azoles, because presenting with azole treatment was not a risk factor for resistance.
trial registrationclinicaltrials.gov Identifier: NCT00996736.
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