Therapeutic efficacy of nitazoxanide on Acanthamoeba keratitis in an experimental model

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Shakour T.Y.; Othman A.A.; Fahmy I.A.; Ali A.Y.A.; Eid A.M.; El-Wakil E.S.; Zoghroban H.S.

Journal: Experimental Eye Research

Publisher: Academic Press

Publication Date: April 2026

Volume / Issue: Volume 265

Article No.: 110858

ISSN: 144835

DOI: 10.1016/j.exer.2026.110858

Scopus: View on Scopus

PubMed: 41525918

Document Type: Article

Authors and Affiliations

Shakour T.Y., Medical Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Egypt; Othman A.A., Medical Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Egypt; Fahmy I.A., Ophthalmic Medicine and Surgery, Research Institute of Ophthalmology, Giza, Egypt; Ali A.Y.A., Ophthalmology Department, Faculty of Medicine, Tanta University, Tanta, Egypt; Eid A.M., Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt; El-Wakil E.S., Department of Parasitology, Theodor Bilharz Research Institute, Giza, Egypt; Zoghroban H.S., Medical Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Egypt

Abstract

Acanthamoeba keratitis (AK) is a serious sight-threatening infection caused by various species of the opportunistic protozoan Acanthamoeba, especially in contact lens wearers and immunocompromised people. The aim of the study was to assess the therapeutic efficacy of two topical nitazoxanide (NTZ) formulations in experimentally induced AK. Three groups of male New Zealand white rabbits were used: group (A): infected and received NTZ in suspension form; group (B): infected and received NTZ in liquid crystal forming system; and group (C): infected and received topical chlorhexidine 0.02 %. The right eyes of the animals served as their corresponding infected untreated control. The animals were infected by Acanthamoeba isolated from human cases of AK. The effects of treatment were assessed over 30 days through daily clinical evaluation; grading of AK; and parasitological and histopathological examination of corneal tissues. The present work revealed that after inducing keratitis, signs of infection appeared on day 3, and all groups showed similar infection rates before treatment began. Corneal opacity improved significantly in animals treated by NTZ liquid crystal form, especially by days 18–30 post-treatment, scoring therapeutic outcomes comparable or superior to the chlorhexidine-treated group and markedly better than the NTZ suspension-treated group. Histopathological assessment confirmed these findings, with the NTZ liquid crystal group exhibiting minimal inflammation and no detectable cysts, highlighting its potential as an effective alternative agent against Acanthamoeba. In conclusion, NTZ in its liquid crystal form showed promise as a potential therapy for AK. Further studies are needed to establish safety and efficacy of topical NTZ in humans and its possible use in combination with other amoebicidal agents. © 2026 Elsevier Ltd

Keywords

Acanthamoeba; Acanthamoeba keratitis; Clinical grading; Histopathology; Nitazoxanide; Animals; Antiparasitic Agents; Cornea; Disease Models, Animal; Eye Infections, Parasitic; Male; Nitro Compounds; Rabbits; Thiazoles; Treatment Outcome; chlorhexidine; DNA 18S; gentamicin; antiparasitic agent; nitro derivative; thiazole derivative; adult; animal experiment; animal model; animal tissue; Article; Campylobacter jejuni; clinical evaluation; comparative study; controlled study; cornea opacity; cornea stroma; cornea tissue; DNA sequencing; enzyme activity; eye examination; eye infection; Helicobacter pylori; infection rate; liquid crystal; microscopy; nonhuman; phylogeny; animal; diagnosis; disease model; drug therapy; isolation and purification; Leporidae; parasitic eye infection; parasitology; pathology

Citation Information

Scopus Citations: 2

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