DOCSLIB.ORG

Onychomycosis/Fungal Apr10

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Onychomycosis/Fungal Apr10 Onychomycosis Treatment & the Antifungal Drug Chart (Chart Pages 1 & 2 printed; 3rd page available online) April 2010 Recent Guidelines: General Overview – Onychomycosis4,5,6,7,8 Oral treatment Canadian : • Onychomycosis is a fungal infection of the nails most • Terbinafine LAMISIL 250mg PO once daily is the Bugs and drugs 2006 commonly caused by dermatophytes. Less often Candida drug of choice (cure rate >50-80%, however relapse is http://www.bugsanddrugs.ca/ and molds may affect the nail. common). Terbinafine is more effective than 12 American : • Onychomycosis is recognized by thickening of the distal itraconazole and able to maintain cure for a longer 13 IDSA Candida guidelines 2009 end of the nail associated with some loosening of the nail duration (2 year follow-up). Terbinafine also has less http://www.journals.uchicago.ed plate from the nail bed. The nail plate shows butter yellow risk for potential drug interactions. u/doi/pdf/10.1086/596757 coloured, vertical bands starting at the distal end of the nail. • Alternate treatments UK Guideline 2003 • Both toenails and finger nails may be affected, but o Itraconazole SPORANOX pulse therapy is an http://bad.org.uk/Portals/_Bad/ dermatophyte infections of fingers seldom occur in the alternative if terbinafine contraindicated. Guidelines/Clinical%20Guidel absence of toenail infections. o Fluconazole DIFLUCAN is less effective but is ines/Onychomycosis.pdf 1 • Fungal infections of the foot are not life-threatening but useful in patients unable to take the above. Review Articles: can cause discomfort and become unsightly. For some, 2009 NEJM: Fungal nail disease they predispose to recurrent cellulitis of the legs. Duration & approach to treatment 14,15 http://content.nejm.org/cgi/reprint/360/ 20/2108.pdf 2 Case discussion • Duration of treatment for terbinafine and itraconazole: Ötoenail 12-16 weeks; fingernail 6 weeks. Cochrane:Topical fungal • Mr. T., a 69 yr old man reports that his big toenail has treatments of the skin & foot some yellow “streaks” and looks different. He has a • Weekly topical terbinafine cream application after 2007 history of recurring tinea pedis. completion of oral treatment may be tried to prevent http://mrw.interscience.wiley.com/ • He has diabetes and is on metformin BID and a small dose reinfection (expert opinion). The cream is applied cochrane/clsysrev/articles/CD001 between toes and around nail margin. 434/pdf_fs.html 3 of Humulin N at bedtime. He started swimming a year ago to improve his health after he had a “mild” heart attack. • Alternate treatments Other Resources: Itraconazole pulse therapy (ie. 200mg po BID for 1 Images of skin diseases, includes other • Upon examination, you notice a yellowish discoloration o dermatologic links: www.dermnet.com mainly under the distal end of a thickened toenail. week per month) may decrease costs, side effects when compared to fixed dose (ie. 200mg po daily). Risk factors for onychomycosis9 Patient Resources: Cure rates are similar with pulsed vs. continuous • Risk factors include: age (increased risk with older age), BMJ Clinical Evidence treatments. {Continuous daily dosing is more 10 16 http://clinicalevidence.bmj.com/ceweb/ gender – males 2.4x at risk than females , history of effective than pulse therapy for terbinafine.} conditions/skd/1715/fungal-toenail- tinea pedis or known infected family members. infections-standard- o Fluconazole 150mg po once weekly (x 6-12 months 17,18 ce_patient_leaflet.pdf • Medical conditions that increase risk of infection include for toenail; x ≥3 months for fingernail). diabetes, immunodeficiency, psoriasis or genetic factors. • To monitor for treatment success, mark the nail at Highlights: • Other contributory factors include: poor peripheral completion of oral treatment. This can be done by 1) Not all abnormal nails are circulation, nail trauma, occlusive shoes, smoking, sports filing a line in the nail at the proximal part of known fungal, treat only if culture activities or other activities involving bare feet. infection and marking with a permanent marker. Ask positive for dermatophyte the patient to return if mark and affected toenail do not When to consider treatment grow out or if infection moves proximal past the 2) To minimize potential for false negative, culture nail clipping • Patients with diabetes and/or additional risk factors for marked line. and deep scrapings cellulitis (i.e. prior cellulitis, venous insufficiency, edema). Onychomycosis may be a predictor of foot Cautions including contraindications 11 3) Treat with terbinafine for 12- ulcer in a diabetic patient . and side effects 16 weeks (drug of choice for • Patient experiencing nail pain or discomfort. • A meta-analysis19 found the risk of severe liver injury toenail onychomycosis) • Cosmetic improvement desired. or asymptomatic elevations of serum transaminases with all treatments to be <2%. Liver enzymes should 4) Mark nail at end of treatment Diagnosis to monitor treatment success be done at baseline and after 4-6 weeks with terbinafine Nail clippings, scrapings under the nail and deep nail • and monthly for itraconazole. RxFiles Related: samples are essential to confirm diagnosis of dermatophyte • Itraconazole is contraindicated in patients with heart infection. This is recommended before starting treatment! Antifungal chart: failure or ventricular dysfunction and in patients using http://www.rxfiles.ca/rxfiles/uploads/docu • If negative for dermatophytes, assess for possible psoriasis, drugs metabolized by CYP 3A4 (see Antifungal Chart). ments/members/cht-antifungal.pdf lichen planus, nail trauma, onycholysis (e.g. distance runners), Topical Steroid Chart: changes due to aging or gel nails, & yellow-nail syndrome. http://www.rxfiles.ca/rxfiles/uploads/docu ments/members/CHT- Other Fungal Infections: Clinical Pearls from the Antifungal Chart (chart, next page &/or online) SteroidClassPotencyCOLOR.pdf Common skin infections Oral candidiasis OTC Chart: Fungal Infections • Nystatin only effective for Candida infections (e.g. diaper • The nystatin dose for oral candidiasis (adult) is usually http://www.rxfiles.ca/rxfiles/uploads/docu rash, intertrigo, vulvovaginal infection). 5ml QID to ensure enough liquid to cover area in mouth ments/members/CHT-OTCs.pdf RxFiles Academic Detailing • Combination products that contain steroids and/or nystatin Vulvovaginal candidiasis (uncomplicated) Saskatoon City Hospital should not be used for dermatophyte infections (e.g. ® • 1-3 days with a topical azole as effective as 6-7 days for Saskatoon, SK Canada Viaderm : nystatin, neomycin, gramicidin & treatment but allow ~3 days for symptom resolution. triamcinolone; Lotriderm:clotrimazole + betamethasone). see www.RxFiles.ca • 7 day topical azole treatment recommended in pregnancy 20 Select drug interactions with antifungals Case Discussion (continued): • Terbinafine has minimal significant drug interactions and is a good • Nail clipping and scraping was cultured and came back positive after antifungal option for patients on multiple drug regimens. As an 4 weeks. Due to patient’s diabetes, potential risk for cellulitis and inhibitor of CYP 2D6, it does still have some potential for drug history of tinea pedis, it was decided to recommend pharmacological interactions including increasing the levels and effect of TCAs, beta- treatment. blockers and antipsychotics. (See also Antifungal Treatment Chart.) • The option of treating, including the benefits, risks and costs were • Itraconazole is a strong CYP 3A4 inhibitor resulting in many discussed. Since he had diabetes, he was deemed to derive frequent and significant drug interactions. The majority of drug substantial benefit. interactions result in increased levels of drugs that may: prolong QT • Terbinafine 250mg once daily x 12 weeks was initiated interval (i.e. amiodarone, quinidine, erythromycin), increase side • Mr T. returned 3 months later after completing a course of treatment effects (digoxin-nausea, vomiting; nifedipine-hypotension, dizziness; and noticed an improvement in his toe appearance. However, it still simvastatin/lovastatin-rhabdomyolysis; repaglinide, pioglitazone?- did not look “normal”. He was reassured that he did not require hypoglycemia) or increase toxicity (i.e. cyclosporine, tacrolimus) additional treatment at this time. The nail was marked at the margin o Strong CYP 3A4 inducers (i.e. phenytoin, grapefruit juice) proximal to the infection and patient counseled to return if the and antacids may decrease itraconazole levels. infection moved past the mark or failed to grow out in the coming • Fluconazole has less potential for major drug interactions than 12-18 months. He was instructed to trim & file the nail as it grew. itraconazole because of its renal elimination and lesser effects as an enzyme inhibitor. (Agent is 3rd line in onychomycosis due to limited efficacy.) Prevention topics to discuss with patient… Penlac • Treatment of tinea pedis Is ciclopirox nail lacquer an option? 21 • Proper footwear e.g. wear sandals/slippers in communal areas such as • Penetration into the nail is limited and use is of minimal value. It is swimming pools, locker rooms, gyms, mosque, etc. slightly more effective when compared to placebo22; no additive 23 • Avoid going barefoot where possible benefit when combined with oral terbinafine • Proper nail hygiene – trim nails short & straight across • Recurrence is common on discontinuation. • Avoid using same nail clippers or files on both diseased and normal nails; • Consider cost of solution:
Load more

Recommended publications
  • Fungal Infections from Human and Animal Contact
    Journal of Patient-Centered Research and Reviews Volume 4 Issue 2 Article 4 4-25-2017 Fungal Infections From Human and Animal Contact Dennis J. Baumgardner Follow this and additional works at: https://aurora.org/jpcrr Part of the Bacterial Infections and Mycoses Commons, Infectious Disease Commons, and the Skin and Connective Tissue Diseases Commons Recommended Citation Baumgardner DJ. Fungal infections from human and animal contact. J Patient Cent Res Rev. 2017;4:78-89. doi: 10.17294/2330-0698.1418 Published quarterly by Midwest-based health system Advocate Aurora Health and indexed in PubMed Central, the Journal of Patient-Centered Research and Reviews (JPCRR) is an open access, peer-reviewed medical journal focused on disseminating scholarly works devoted to improving patient-centered care practices, health outcomes, and the patient experience. REVIEW Fungal Infections From Human and Animal Contact Dennis J. Baumgardner, MD Aurora University of Wisconsin Medical Group, Aurora Health Care, Milwaukee, WI; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI; Center for Urban Population Health, Milwaukee, WI Abstract Fungal infections in humans resulting from human or animal contact are relatively uncommon, but they include a significant proportion of dermatophyte infections. Some of the most commonly encountered diseases of the integument are dermatomycoses. Human or animal contact may be the source of all types of tinea infections, occasional candidal infections, and some other types of superficial or deep fungal infections. This narrative review focuses on the epidemiology, clinical features, diagnosis and treatment of anthropophilic dermatophyte infections primarily found in North America.
    [Show full text]
  • The National Drugs List
    ^ ^ ^ ^ ^[ ^ The National Drugs List Of Syrian Arab Republic Sexth Edition 2006 ! " # "$ % &'() " # * +$, -. / & 0 /+12 3 4" 5 "$ . "$ 67"5,) 0 " /! !2 4? @ % 88 9 3: " # "$ ;+<=2 – G# H H2 I) – 6( – 65 : A B C "5 : , D )* . J!* HK"3 H"$ T ) 4 B K<) +$ LMA N O 3 4P<B &Q / RS ) H< C4VH /430 / 1988 V W* < C A GQ ") 4V / 1000 / C4VH /820 / 2001 V XX K<# C ,V /500 / 1992 V "!X V /946 / 2004 V Z < C V /914 / 2003 V ) < ] +$, [2 / ,) @# @ S%Q2 J"= [ &<\ @ +$ LMA 1 O \ . S X '( ^ & M_ `AB @ &' 3 4" + @ V= 4 )\ " : N " # "$ 6 ) G" 3Q + a C G /<"B d3: C K7 e , fM 4 Q b"$ " < $\ c"7: 5) G . HHH3Q J # Hg ' V"h 6< G* H5 !" # $%" & $' ,* ( )* + 2 ا اوا ادو +% 5 j 2 i1 6 B J' 6<X " 6"[ i2 "$ "< * i3 10 6 i4 11 6! ^ i5 13 6<X "!# * i6 15 7 G!, 6 - k 24"$d dl ?K V *4V h 63[46 ' i8 19 Adl 20 "( 2 i9 20 G Q) 6 i10 20 a 6 m[, 6 i11 21 ?K V $n i12 21 "% * i13 23 b+ 6 i14 23 oe C * i15 24 !, 2 6\ i16 25 C V pq * i17 26 ( S 6) 1, ++ &"r i19 3 +% 27 G 6 ""% i19 28 ^ Ks 2 i20 31 % Ks 2 i21 32 s * i22 35 " " * i23 37 "$ * i24 38 6" i25 39 V t h Gu* v!* 2 i26 39 ( 2 i27 40 B w< Ks 2 i28 40 d C &"r i29 42 "' 6 i30 42 " * i31 42 ":< * i32 5 ./ 0" -33 4 : ANAESTHETICS $ 1 2 -1 :GENERAL ANAESTHETICS AND OXYGEN 4 $1 2 2- ATRACURIUM BESYLATE DROPERIDOL ETHER FENTANYL HALOTHANE ISOFLURANE KETAMINE HCL NITROUS OXIDE OXYGEN PROPOFOL REMIFENTANIL SEVOFLURANE SUFENTANIL THIOPENTAL :LOCAL ANAESTHETICS !67$1 2 -5 AMYLEINE HCL=AMYLOCAINE ARTICAINE BENZOCAINE BUPIVACAINE CINCHOCAINE LIDOCAINE MEPIVACAINE OXETHAZAINE PRAMOXINE PRILOCAINE PREOPERATIVE MEDICATION & SEDATION FOR 9*: ;< " 2 -8 : : SHORT -TERM PROCEDURES ATROPINE DIAZEPAM INJ.
    [Show full text]
  • Estimated Burden of Fungal Infections in Oman
    Journal of Fungi Article Estimated Burden of Fungal Infections in Oman Abdullah M. S. Al-Hatmi 1,2,3,* , Mohammed A. Al-Shuhoumi 4 and David W. Denning 5 1 Department of microbiology, Natural & Medical Sciences Research Center, University of Nizwa, Nizwa 616, Oman 2 Department of microbiology, Centre of Expertise in Mycology Radboudumc/CWZ, 6500 Nijmegen, The Netherlands 3 Foundation of Atlas of Clinical Fungi, 1214GP Hilversum, The Netherlands 4 Ibri Hospital, Ministry of Health, Ibri 115, Oman; [email protected] 5 Manchester Fungal Infection Group, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, UK; [email protected] * Correspondence: [email protected]; Tel.: +968-25446328; Fax: +968-25446612 Abstract: For many years, fungi have emerged as significant and frequent opportunistic pathogens and nosocomial infections in many different populations at risk. Fungal infections include disease that varies from superficial to disseminated infections which are often fatal. No fungal disease is reportable in Oman. Many cases are admitted with underlying pathology, and fungal infection is often not documented. The burden of fungal infections in Oman is still unknown. Using disease frequencies from heterogeneous and robust data sources, we provide an estimation of the incidence and prevalence of Oman’s fungal diseases. An estimated 79,520 people in Oman are affected by a serious fungal infection each year, 1.7% of the population, not including fungal skin infections, chronic fungal rhinosinusitis or otitis externa. These figures are dominated by vaginal candidiasis, followed by allergic respiratory disease (fungal asthma). An estimated 244 patients develop invasive aspergillosis and at least 230 candidemia annually (5.4 and 5.0 per 100,000).
    [Show full text]
  • Candida Auris
    microorganisms Review Candida auris: Epidemiology, Diagnosis, Pathogenesis, Antifungal Susceptibility, and Infection Control Measures to Combat the Spread of Infections in Healthcare Facilities Suhail Ahmad * and Wadha Alfouzan Department of Microbiology, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait; [email protected] * Correspondence: [email protected]; Tel.: +965-2463-6503 Abstract: Candida auris, a recently recognized, often multidrug-resistant yeast, has become a sig- nificant fungal pathogen due to its ability to cause invasive infections and outbreaks in healthcare facilities which have been difficult to control and treat. The extraordinary abilities of C. auris to easily contaminate the environment around colonized patients and persist for long periods have recently re- sulted in major outbreaks in many countries. C. auris resists elimination by robust cleaning and other decontamination procedures, likely due to the formation of ‘dry’ biofilms. Susceptible hospitalized patients, particularly those with multiple comorbidities in intensive care settings, acquire C. auris rather easily from close contact with C. auris-infected patients, their environment, or the equipment used on colonized patients, often with fatal consequences. This review highlights the lessons learned from recent studies on the epidemiology, diagnosis, pathogenesis, susceptibility, and molecular basis of resistance to antifungal drugs and infection control measures to combat the spread of C. auris Citation: Ahmad, S.; Alfouzan, W. Candida auris: Epidemiology, infections in healthcare facilities. Particular emphasis is given to interventions aiming to prevent new Diagnosis, Pathogenesis, Antifungal infections in healthcare facilities, including the screening of susceptible patients for colonization; the Susceptibility, and Infection Control cleaning and decontamination of the environment, equipment, and colonized patients; and successful Measures to Combat the Spread of approaches to identify and treat infected patients, particularly during outbreaks.
    [Show full text]
  • (Schizotrypanum) Cruzi in Dog Hosts Paulo Marcos Da Matta Guedes,1 Julio A
    ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Nov. 2004, p. 4286–4292 Vol. 48, No. 11 0066-4804/04/$08.00ϩ0 DOI: 10.1128/AAC.48.11.4286–4292.2004 Copyright © 2004, American Society for Microbiology. All Rights Reserved. Activity of the New Triazole Derivative Albaconazole against Trypanosoma (Schizotrypanum) cruzi in Dog Hosts Paulo Marcos da Matta Guedes,1 Julio A. Urbina,2 Marta de Lana,3 Luis C. C. Afonso,1 Vanja M. Veloso,1 Washington L. Tafuri,1 George L. L. Machado-Coelho,4 Egler Chiari,5 and Maria Terezinha Bahia1* Departamento de Cieˆncias Biolo´gicas,1 Departamento de Ana´lises Clínicas,3 and Departamento de Farma´cia,4 Universidade Federal de Ouro Preto, Ouro Preto, and Departamento de Parasitologia, Universidade Federal de Minas Gerais, Belo Horizonte,5 Minas Gerais, Brazil, and Centro de Biofísica y Bioquímica, Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela2 Received 25 March 2004/Returned for modification 8 June 2004/Accepted 20 July 2004 Albaconazole is an experimental triazole derivative with potent and broad-spectrum antifungal activity and a remarkably long half-life in dogs, monkeys, and humans. In the present work, we investigated the in vivo activity of this compound against two strains of the protozoan parasite Trypanosoma (Schizotrypanum) cruzi, the causative agent of Chagas’ disease, using dogs as hosts. The T. cruzi strains used in the study were previously characterized (murine model) as susceptible (strain Berenice-78) and partially resistant (strain Y) to the drugs currently in clinical use, nifurtimox and benznidazole. Our results demonstrated that albaconazole is very effective in suppressing the proliferation of the parasite and preventing the death of infected animals.
    [Show full text]
  • Mycamine (Micafungin) Safety and Drug Utilization Review
    Department of Health and Human Services Public Health Service Food and Drug Administration Center for Drug Evaluation and Research Office of Surveillance and Epidemiology Pediatric Postmarketing Pharmacovigilance and Drug Utilization Review Date: February 26, 2016 Safety Evaluator: Timothy Jancel, PharmD, BCPS (AQ-ID) Division of Pharmacovigilance II (DPV II) Drug Use Analyst: LCDR Justin Mathew, PharmD Division of Epidemiology II (DEPI II) Team Leaders: Kelly Cao, PharmD Division of Pharmacovigilance II (DPV II) Rajdeep Gill, PharmD Division of Epidemiology II (DEPI II) Deputy Directors: S. Christopher Jones, PharmD, MS, MPH Division of Pharmacovigilance II (DPV II) LCDR Grace Chai, Pharm.D Division of Epidemiology II (DEPI II) Product Name(s): Mycamine® (micafungin) Pediatric Labeling Approval Date: June 21, 2013 Application Type/Number: NDA 021506 Applicant/Sponsor: Astellas OSE RCM #: 2015-1945 **This document contains proprietary drug use data obtained by FDA under contract. The drug use data/information cannot be released to the public/non-FDA personnel without contractor approval obtained through the FDA/CDER Office of Surveillance and Epidemiology.** Reference ID: 3893564 TABLE OF CONTENTS Executive Summary.........................................................................................................................3 1 Introduction..............................................................................................................................4 1.1 Pediatric Regulatory History.............................................................................................4
    [Show full text]
  • Onychomycosis/ (Suspected) Fungal Nail and Skin Protocol
    Onychomycosis/ (suspected) Fungal Nail and Skin Protocol Please check the boxes of the evaluation questions, actions and dispensing items you wish to include in your customized protocol. If additional or alternative products or services are provided, please include when making your selections. If you wish to include the condition description please also check the box. Description of Condition: Onychomycosis is a common nail condition. It is a fungal infection of the nail that differs from bacterial infections (often referred to as paronychia infections). It is very common for a patient to present with onychomycosis without a true paronychia infection. It is also very common for a patient with a paronychia infection to have secondary onychomycosis. Factors that can cause onychomycosis include: (1) environment: dark, closed, and damp like the conventional shoe, (2) trauma: blunt or repetitive, (3) heredity, (4) compromised immune system, (5) carbohydrate-rich diet, (6) vitamin deficiency or thyroid issues, (7) poor circulation or PVD, (8) poor-fitting shoe gear, (9) pedicures received in places with unsanitary conditions. Nails that are acute or in the early stages of infection may simply have some white spots or a white linear line. Chronic nail conditions may appear thickened, discolored, brittle or hardened (to the point that the patient is unable to trim the nails on their own). The nails may be painful to touch or with closed shoe gear or the nail condition may be purely cosmetic and not painful at all. *Ask patient to remove nail
    [Show full text]
  • Vaginal Yeast Infections Yeast Are Caused Byinfection an Overgrowth of Yeast in the Vagina
    •Vaginal Yeast infections Yeast are caused byInfection an overgrowth of yeast in the vagina. • Yeast infections can be treated with over-the-counter medications. • Many yeast infections can be treated without seeing a medical provider. Symptoms: • Vaginal Itching, burning, swelling • Vaginal discharge (thick white vaginal discharge that looks like cottage cheese and does not have a bad smell) • May have pain during sex • May be worse the week before your period Self-care measures: • Use an over-the-counter medication for vaginal yeast infections. These antifungal medications should contain butoconazole, clotrimazole, miconazole, or tioconazole and should be used for 3-7 days. Follow directions on medication insert. Note: Over-the-counter medications are available at the University Health Center Pharmacy (first floor of Student Success Center), local pharmacies, grocery stores and superstores (examples - Walmart or Target). • Change tampons, pads and panty liners often • Do wear underwear with a cotton crotch • Apply a cool compress to labia for comfort • Do not douche or use vaginal sprays • Do not wear tight underwear and do not wear underwear to sleep • Avoid hot tubs Limit spread to others: • It is possible to spread yeast infections to your partner(s) during vaginal, oral or anal sex. • If your partner is a male, the risk is low. Some men get an itchy rash on their penis. • If this happens have your partner see a medical provider. • If your partner is a female, you may spread the yeast infection to her. • She should be treated if she
    [Show full text]
  • PHARMACEUTICAL APPENDIX to the TARIFF SCHEDULE 2 Table 1
    Harmonized Tariff Schedule of the United States (2020) Revision 19 Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE HARMONIZED TARIFF SCHEDULE Harmonized Tariff Schedule of the United States (2020) Revision 19 Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE TARIFF SCHEDULE 2 Table 1. This table enumerates products described by International Non-proprietary Names INN which shall be entered free of duty under general note 13 to the tariff schedule. The Chemical Abstracts Service CAS registry numbers also set forth in this table are included to assist in the identification of the products concerned. For purposes of the tariff schedule, any references to a product enumerated in this table includes such product by whatever name known.
    [Show full text]
  • Managing Athlete's Foot
    South African Family Practice 2018; 60(5):37-41 S Afr Fam Pract Open Access article distributed under the terms of the ISSN 2078-6190 EISSN 2078-6204 Creative Commons License [CC BY-NC-ND 4.0] © 2018 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0 REVIEW Managing athlete’s foot Nkatoko Freddy Makola,1 Nicholus Malesela Magongwa,1 Boikgantsho Matsaung,1 Gustav Schellack,2 Natalie Schellack3 1 Academic interns, School of Pharmacy, Sefako Makgatho Health Sciences University 2 Clinical research professional, pharmaceutical industry 3 Professor, School of Pharmacy, Sefako Makgatho Health Sciences University *Corresponding author, email: [email protected] Abstract This article is aimed at providing a succinct overview of the condition tinea pedis, commonly referred to as athlete’s foot. Tinea pedis is a very common fungal infection that affects a significantly large number of people globally. The presentation of tinea pedis can vary based on the different clinical forms of the condition. The symptoms of tinea pedis may range from asymptomatic, to mild- to-severe forms of pain, itchiness, difficulty walking and other debilitating symptoms. There is a range of precautionary measures available to prevent infection, and both oral and topical drugs can be used for treating tinea pedis. This article briefly highlights what athlete’s foot is, the different causes and how they present, the prevalence of the condition, the variety of diagnostic methods available, and the pharmacological and non-pharmacological management of the
    [Show full text]
  • Therapeutic Class Overview Antifungals, Topical
    Therapeutic Class Overview Antifungals, Topical INTRODUCTION The topical antifungals are available in multiple dosage forms and are indicated for a number of fungal infections and related conditions. In general, these agents are Food and Drug Administration (FDA)-approved for the treatment of cutaneous candidiasis, onychomycosis, seborrheic dermatitis, tinea corporis, tinea cruris, tinea pedis, and tinea versicolor (Clinical Pharmacology 2018). The antifungals may be further classified into the following categories based upon their chemical structures: allylamines (naftifine, terbinafine [only available over the counter (OTC)]), azoles (clotrimazole, econazole, efinaconazole, ketoconazole, luliconazole, miconazole, oxiconazole, sertaconazole, sulconazole), benzylamines (butenafine), hydroxypyridones (ciclopirox), oxaborole (tavaborole), polyenes (nystatin), thiocarbamates (tolnaftate [no FDA-approved formulations]), and miscellaneous (undecylenic acid [no FDA-approved formulations]) (Micromedex 2018). The topical antifungals are available as single entity and/or combination products. Two combination products, nystatin/triamcinolone and Lotrisone (clotrimazole/betamethasone), contain an antifungal and a corticosteroid preparation. The corticosteroid helps to decrease inflammation and indirectly hasten healing time. The other combination product, Vusion (miconazole/zinc oxide/white petrolatum), contains an antifungal and zinc oxide. Zinc oxide acts as a skin protectant and mild astringent with weak antiseptic properties and helps to
    [Show full text]
  • Lactoferrin, Chitosan and Melaleuca Alternifolia—Natural Products That
    b r a z i l i a n j o u r n a l o f m i c r o b i o l o g y 4 9 (2 0 1 8) 212–219 ht tp://www.bjmicrobiol.com.br/ Review Lactoferrin, chitosan and Melaleuca alternifolia—natural products that show promise in candidiasis treatment ∗ Lorena de Oliveira Felipe , Willer Ferreira da Silva Júnior, Katialaine Corrêa de Araújo, Daniela Leite Fabrino Universidade Federal de São João del-Rei/Campus Alto Paraopeba, Minas Gerais, MG, Brazil a r t i c l e i n f o a b s t r a c t Article history: The evolution of microorganisms resistant to many medicines has become a major chal- Received 18 August 2016 lenge for the scientific community around the world. Motivated by the gravity of such a Accepted 26 May 2017 situation, the World Health Organization released a report in 2014 with the aim of providing Available online 11 November 2017 updated information on this critical scenario. Among the most worrying microorganisms, Associate Editor: Luis Henrique species from the genus Candida have exhibited a high rate of resistance to antifungal drugs. Guimarães Therefore, the objective of this review is to show that the use of natural products (extracts or isolated biomolecules), along with conventional antifungal therapy, can be a very promising Keywords: strategy to overcome microbial multiresistance. Some promising alternatives are essential Candida oils of Melaleuca alternifolia (mainly composed of terpinen-4-ol, a type of monoterpene), lacto- Lactoferrin ferrin (a peptide isolated from milk) and chitosan (a copolymer from chitin).
    [Show full text]