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Polihexanide 0.8 mg/ml eye drops for treating acanthamoeba keratitis in people 12 years and over

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1 Recommendations

1.1

Polihexanide 0.8 mg/ml eye drops should not be used to treat acanthamoeba keratitis in people 12 years and over.

1.2

This recommendation is not intended to affect treatment with polihexanide 0.8 mg/ml eye drops that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS healthcare professional consider it appropriate to stop. For young people, this decision should be made jointly by the healthcare professional, the young person, and their parents or carers.

What this means in practice

Polihexanide 0.8 mg/ml eye drops are not required to be funded and should not be used routinely in the NHS in England for the condition and population in the recommendations.

This is because there is not enough evidence to determine if polihexanide 0.8 mg/ml eye drops are value for money.

Why the committee made these recommendations

Usual treatment for acanthamoeba keratitis is unlicensed and off-label anti-amoebic therapies (AATs) alone or in combination. These include chlorhexidine, polihexanide (0.2 mg/ml and 0.6 mg/ml), propamidine and hexamidine.

Clinical trial evidence suggests that polihexanide 0.8 mg/ml eye drops with placebo have similar effectiveness to polihexanide 0.2 mg/ml with propamidine. But there is some uncertainty around the results.

Polihexanide 0.8 mg/ml eye drops have not been directly compared in a clinical trial with other AATs and the results of indirect comparisons are uncertain.

Because of the uncertainties in the clinical evidence, it is not possible to determine the most likely cost-effectiveness estimate for polihexanide 0.8 mg/ml eye drops.

So, polihexanide 0.8 mg/ml eye drops should not be used.