Effects of Noncompliance with Multiple Drugs in the Treatment of Fungal Corneal Ulcer

Abstract

A prospective, observational study was conducted in a tertiary level specialized institution in Bangladesh, between February and August of 2023, to assess the effect of noncompliance with multiple drugs in treating fungal corneal ulcers. A total of 100 patients with fungal corneal ulcers from the cornea outpatient department were enrolled in this study. They were checked in for study on the first week, second week, after one month and after two months. Visual acuity, size of the ulcer, grade of opacity, level of hypopyon, and compliance with drugs were recorded (measured by MMAS-8). All data were recorded on a predesigned data collection sheet and analyzed. Out of 100 corneal ulcer patients, 47 were found to have therapeutic failure. The patient's level of education, place of residence, kind of trauma, and patient compliance were identified as possible risk factors for treatment failure on bivariate analysis. The respondents identified the frequency and use of multiple drugs as the primary reasons for noncompliance. It was found that patients' willingness to cooperate significantly influenced the success of their medical treatment. Compared to medium-compliant patients, patients with lesser compliance had a 4.4 times increased risk of not receiving medical treatment (OR: 4.408; p<0.05). One of the main contributing factors to treatment failure for corneal ulcers is noncompliance. Key components to improving compliance are reducing the frequency of doses, avoiding multiple medications, and improving the patient's awareness and comprehension of the illness.  

CBMJ 2026 July: Vol. 15 No. 02 P:49-57