Thulasi P, Saeed HN, Rapuano CJ, et al. - Researchers reported a case series of patients with treatment-resistant Acanthamoeba keratitis (AK) utilizing oral miltefosine, often as salvage therapy. Between 2011 and 2017, 15 patients with AK unresponsive to therapy who were subsequently given adjuvant systemic miltefosine were reviewed. Until beginning miltefosine, all patients were treated with biguanides and/or diamidines or azoles without disease resolution. Eleven of 15 patients retained count fingers or better vision, and all were considered disease-free at last follow up. In patients with refractory AK, oral miltefosine is a generally well-tolerated treatment adjuvant. For a steroid-responsive inflammatory response frequently encountered during the treatment course, the clinician should be prepared.