Mechanism of Drug Failure in Fusarium Keratitis, 2004–2006

From 2004 through 2006, fusarium keratitis associated with contact lens use was recognized. In this letter, a potential mechanism for this event is identified. To the Editor: Between 2004 and 2006, fusarium keratitis developed in hundreds of patients in Hong Kong, Singapore, the United States, and the French West Indies. The infections were traced to a specific multipurpose contact lens solution that was manufactured at one facility. This solution contained the antimicrobial agent alexidine dihydrochloride (0.00045%), an ingredient that was new to the contact lens–solution market at that time. The manufacturer was subsequently cited by the Food and Drug Administration (FDA) for inadequate temperature control of their products, and the contact lens solution, ReNu with MoistureLoc (Bausch & Lomb), was ultimately withdrawn from the . . .