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This abstract is assigned to session AOB Free Papers 2

Presentation type	Oral presentation
Title	PHMB supply: the key to successful treatment

Purpose	Polyhexamethylenbiguanid (PHMB) has been proven to be an effective treatment for Acanthamoeba Keratitis (AK) but is not yet listed on the ‘Belgisch centrum voor farmacotherapeutische informatie’ (BCFI). In this study, we describe a case successfully treated with PHMB and how we established a reliable PHMB supply chain for our hospital.
Methods	In October a patient presented to our department with clinical signs of AK after wearing Halloween contact lenses. Initial treatment with chlorhexidine 0.02% and Brolene only led to a slight improvement for the patient’s eye. Identifying the need for PHMB in Belgium we started the project of organizing a reliable, affordable PHMB supply chain in our hospital. In collaboration with our hospital pharmacy, a local pharmacy, and a pharmacy in Germany we identified a suitable supplier (SeragWiessner, Germany) for PHMB solution. The other ingredients of the solutions were reviewed to confirm that they were commonly used in eye care and safe to use. The pH of the solution was verified at 5.9 by our pharmacy.
Results	We established a reliable PHMB supply chain for our hospital and started the patient on 0.02% PHMB 4 times daily. This resulted in significant clinical improvement and pinhole visual acuity improved from 0.4 to 0.9 after 4 weeks of treatment.
Conclusion	The results underscore the need for effective AK medication for our patients in Belgium. Biggest obstacles in establishing a local PHMB supply chain was identifying a suitable supplier and how to guarantee product safety and quality, while import from an EU country proved manageable in collaboration with our hospital pharmacy. To ensure widespread PHMB access for every AK patient, PHMB should be listed on the BCFI and be reimbursed.
Conflict of interest	No

Authors 1

Last name	HERMANN
Initials	M
Department	Oftalmologie UZ Brussel
City	Brussel

Authors 2

Last name	Ni Dhubhghaill
Initials	S
Department	Oftalmologie UZ Brussel
City	Brussel