The Polyene Antimycotics Nystatin and Filipin Disrupt the Plasma
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Antibiofilm Efficacy of Tea Tree Oil and of Its Main Component Terpinen-4-Ol Against Candida Albicans
ORIGINAL RESEARCH Periodontics Antibiofilm efficacy of tea tree oil and of its main component terpinen-4-ol against Candida albicans Renata Serignoli Abstract: Candida infection is an important cause of morbidity FRANCISCONI(a) and mortality in immunocompromised patients. The increase in its Patricia Milagros Maquera incidence has been associated with resistance to antimicrobial therapy HUACHO(a) and biofilm formation. The aim of this study was to evaluate the Caroline Coradi TONON(a) efficacy of tea tree oil (TTO) and its main component – terpinen-4-ol – Ester Alves Ferreira BORDINI(a) against resistant Candida albicans strains (genotypes A and B) identified by molecular typing and against C. albicans ATCC 90028 and SC 5314 Marília Ferreira CORREIA(a) reference strains in planktonic and biofilm cultures. The minimum Janaína de Cássia Orlandi inhibitory concentration, minimum fungicidal concentration, and SARDI(b) rate of biofilm development were used to evaluate antifungal activity. Denise Madalena Palomari Results were obtained from analysis of the biofilm using the cell (a) SPOLIDORIO proliferation assay 2,3-Bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H- tetrazolium-5-carboxanilide (XTT) and confocal laser scanning (a) Universidade Estadual Paulista – Unesp, microscopy (CLSM). Terpinen-4-ol and TTO inhibited C. albicans School of Dentistry of Araraquara, Department of Physiology and Pathology, growth. CLSM confirmed that 17.92 mg/mL of TTO and 8.86 mg/mL Araraquara, SP, Brazil of terpinen-4-ol applied for 60 s (rinse simulation) interfered with (b) Universidade Estadual de Campinas – biofilm formation. Hence, this in vitro study revealed that natural Unicamp, School of Dentistry of Piracicaba, substances such as TTO and terpinen-4-ol present promising results Department of Physiological Sciences, for the treatment of oral candidiasis. -
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 -
Systemic Antifungal Drug Use in Belgium—
Received: 7 October 2018 | Revised: 28 March 2019 | Accepted: 14 March 2019 DOI: 10.1111/myc.12912 ORIGINAL ARTICLE Systemic antifungal drug use in Belgium—One of the biggest antifungal consumers in Europe Berdieke Goemaere1 | Katrien Lagrou2,3* | Isabel Spriet4,5 | Marijke Hendrickx1 | Eline Vandael6 | Pierre Becker1 | Boudewijn Catry6,7 1BCCM/IHEM Fungal Collection, Service of Mycology and Aerobiology, Sciensano, Summary Brussels, Belgium Background: Reports on the consumption of systemic antifungal drugs on a national 2 Department of Microbiology and level are scarce although of high interest to compare trends and the associated epi- Immunology, KU Leuven, Leuven, Belgium 3Clinical Department of Laboratory demiology in other countries and to assess the need for antifungal stewardship Medicine, National Reference Centre for programmes. Mycosis, University Hospitals Leuven, Leuven, Belgium Objectives: To estimate patterns of Belgian inpatient and outpatient antifungal use 4Department of Pharmaceutical and and provide reference data for other countries. Pharmacological Sciences, KU Leuven, Methods: Consumption records of antifungals were collected in Belgian hospitals Leuven, Belgium between 2003 and 2016. Primary healthcare data were available for the azoles for 5Pharmacy Department, University Hospitals Leuven, Leuven, Belgium the period 2010-2016. 6 Healthcare‐Associated Infections and Results: The majority of the antifungal consumption resulted from prescriptions of Antimicrobial Resistance, Sciensano, Brussels, Belgium fluconazole and itraconazole in the ambulatory care while hospitals were responsible 7Faculty of Medicine, Université Libre de for only 6.4% of the total national consumption and echinocandin use was limited. Bruxelles (ULB), Brussels, Belgium The annual average antifungal consumption in hospitals decreased significantly by Correspondence nearly 25% between 2003 and 2016, due to a decrease solely in non-university hos- Berdieke Goemaere, Sciensano, Mycology pitals. -
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 -
Therapeutic Drug Class
BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID EFFECTIVE PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA 07/01/13 This is not an all-inclusive list of available covered drugs and includes only managed categories. Refer to cover page for complete list of rules governing this PDL. Version 2013.3c Prior authorization for a non-preferred agent in any category will be given only if there has been a trial of the preferred brand/generic equivalent or preferred formulation of the active ingredient, at a therapeutic dose, that resulted in a partial response with a documented intolerance. Prior authorization of a non-preferred isomer, pro-drug, or metabolite will be considered with a trial of a preferred parent drug of the same chemical entity, at a therapeutic dose, that resulted in a partial response with documented intolerance or a previous trial and therapy failure, at a therapeutic dose, with a preferred drug of a different chemical entity indicated to treat the submitted diagnosis. (The required trial may be overridden when documented evidence is provided that the use of these preferred agent(s) would be medically contraindicated.) Unless otherwise specified, the listing of a particular brand or generic name includes all legend forms of that drug. OTC drugs are not covered unless specified. PA criteria for non-preferred agents apply in addition to general Drug Utilization Review policy that is in effect for the entire pharmacy program, including, but not limited to, appropriate dosing, duplication of therapy, etc. The use of pharmaceutical samples will not be considered when evaluating the members’ medical condition or prior prescription history for drugs that require prior authorization. -
A Ketoconazole Susceptibility Test for Malassezia Pachydermatis Using Modified Leeming–Notman Agar
Journal of Fungi Article A Ketoconazole Susceptibility Test for Malassezia pachydermatis Using Modified Leeming–Notman Agar Bo-Young Hsieh 1,2, Wei-Hsun Chao 3, Yi-Jing Xue 2 and Jyh-Mirn Lai 2,* 1 Lugu Township Administration, Nanto County 55844, Taiwan; [email protected] 2 College of Veterinary Medicine, National Chiayi University, No. 580, XinMin Rd., Chiayi City 60054, Taiwan; [email protected] 3 Department of Hospitality Management, WuFung University, Chiayi City 60054, Taiwan; [email protected] * Correspondence: [email protected]; Tel.: +886-5-2732920; Fax: +886-5-2732917 Received: 18 September 2018; Accepted: 14 November 2018; Published: 16 November 2018 Abstract: The aim of this study was to establish a ketoconazole susceptibility test for Malassezia pachydermatis using modified Leeming–Notman agar (mLNA). The susceptibilities of 33 M. pachydermatis isolates obtained by modified CLSI M27-A3 method were compared with the results by disk diffusion method, which used different concentrations of ketoconazole on 6 mm diameter paper disks. Results showed that 93.9% (31/33) of the minimum inhibitory concentration (MIC) values obtained from both methods were similar (consistent with two methods within 2 dilutions). M. pachydermatis BCRC 21676 and Candida parapsilosis ATCC 22019 were used to verify the results obtained from the disk diffusion and modified CLSI M27-A3 tests, and they were found to be consistent. Therefore, the current study concludes that this new novel test—using different concentrations of reagents on cartridge disks to detect MIC values against ketoconazole—can be a cost-effective, time-efficient, and less technically demanding alternative to existing methods. -
NATACYN® (Natamycin Ophthalmic Suspension) 5% Sterile
NATACYN® (natamycin ophthalmic suspension) 5% Sterile DESCRIPTION: NATACYN® (natamycin ophthalmic suspension) 5% is a sterile, antifungal drug for topical ophthalmic administration. Each mL of NATACYN® (natamycin ophthalmic suspension) contains: Active: natamycin 5% (50 mg). Preservative: benzalkonium chloride 0.02%. Inactive: sodium hydroxide and/or hydrochloric acid (neutralized to adjust the pH), purified water. The active ingredient is represented by the chemical structure: Established Name: Natamycin Molecular Formula: C33H47NO13 Molecular Weight: 665.73 g/mol Chemical Name: Stereoisomer of 22-[(3-amino-3,6-dideoxy- β-D-mannopyranosyl)oxy]-1,3,26- trihydroxy-12-methyl-10-oxo-6,11,28-trioxatricyclo[22.3.1.05,7] octacosa-8,14,16,18,20-pentaene-25- carboxylic acid. Other: Pimaricin The pH range is 5.0-7.5. CLINICAL PHARMACOLOGY: Natamycin is a tetraene polyene antibiotic derived from Streptomyces natalensis. It possesses in vitro activity against a variety of yeast and filamentous fungi, including Candida, Aspergillus, Cephalosporium, Fusarium and Penicillium. The mechanism of action appears to be through binding of the molecule to the sterol moiety of the fungal cell membrane. The polyenesterol complex alters the permeability of the membrane to produce depletion of essential cellular constituents. Although the activity against fungi is dose-related, natamycin is predominantly fungicidal. Natamycin is not effective in vitro against gram-positive or gram- negative bacteria. Topical administration appears to produce effective concentrations of natamycin within the corneal stroma but not in intraocular fluid. Systemic absorption should not be expected following topical administration of NATACYN® (natamycin ophthalmic suspension) 5%. As with other polyene antibiotics, absorption from the gastrointestinal tract is very poor. -
Infectious Keratitis: Short Answers
Q Infectious keratitis: Short answers What is the #1 bacterium in CL-related K ulcer? A Infectious keratitis: Short answers What is the #1 bacterium in CL-related K ulcer? Pseudomonas Infectious keratitis: Short answers Pseudomonas corneal ulcer associated with CL wear Q Infectious keratitis: Short answers What is the #1 bacterium in CL-related K ulcer? Pseudomonas What is the #1 risk factor for Acanthamoeba keratitis? A Infectious keratitis: Short answers What is the #1 bacterium in CL-related K ulcer? Pseudomonas What is the #1 risk factor for Acanthamoeba keratitis? CL wear Infectious keratitis: Short answers Acanthamoeba keratitis associated with CL wear Q Infectious keratitis: Short answers What is the #1 bacterium in CL-related K ulcer? Pseudomonas What is the #1 risk factor for Acanthamoeba keratitis? CL wear What are the three main culprits in fungal keratitis? What is the topical antifungal of choice for each? Fusarium:fungus 1 Topical…natamycin Aspergillisfungus 2 and Candida:fungus 3 A Infectious keratitis: Short answers What is the #1 bacterium in CL-related K ulcer? Pseudomonas What is the #1 risk factor for Acanthamoeba keratitis? CL wear What are the three main culprits in fungal keratitis? What is the topical antifungal of choice for each? Candida: Topical…natamycin Aspergillis and Fusarium: Q Infectious keratitis: Short answers What is the #1 bacterium in CL-related K ulcer? Pseudomonas What is the #1 risk factor for Acanthamoeba keratitis? CL wear What are the three main culprits in fungal keratitis? -
IJP: Drugs and Drug Resistance 8 (2018) 246–264
IJP: Drugs and Drug Resistance 8 (2018) 246–264 Contents lists available at ScienceDirect IJP: Drugs and Drug Resistance journal homepage: www.elsevier.com/locate/ijpddr Genomic and transcriptomic alterations in Leishmania donovani lines T experimentally resistant to antileishmanial drugs Alberto Rastrojoa,1, Raquel García-Hernándezb,1, Paola Vargasb, Esther Camachoa, Laura Corvoa, Hideo Imamurac, Jean-Claude Dujardinc, Santiago Castanysb, Begoña Aguadoa, ∗∗ ∗ Francisco Gamarrob, , Jose M. Requenaa, a Centro de Biología Molecular “Severo Ochoa” (CSIC-UAM), Universidad Autónoma de Madrid, Madrid, Spain b Instituto de Parasitología y Biomedicina ‘‘López-Neyra’’ (IPBLN-CSIC), Granada, Spain c Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium ARTICLE INFO ABSTRACT Keywords: Leishmaniasis is a serious medical issue in many countries around the World, but it remains largely neglected in Leishmania donovani terms of research investment for developing new control and treatment measures. No vaccines exist for human Genome use, and the chemotherapeutic agents currently used are scanty. Furthermore, for some drugs, resistance and Transcriptome treatment failure are increasing to alarming levels. The aim of this work was to identify genomic and tran- Trivalent antimony criptomic alterations associated with experimental resistance against the common drugs used against VL: tri- Amphotericin B valent antimony (SbIII, S line), amphotericin B (AmB, A line), miltefosine (MIL, M line) and paromomycin (PMM, Miltefosine ff fi Paromomycin P line). A total of 1006 di erentially expressed transcripts were identi ed in the S line, 379 in the A line, 146 in 24-Sterol methyltransferase the M line, and 129 in the P line. Also, changes in ploidy of chromosomes and amplification/deletion of par- D-lactate dehydrogenase ticular regions were observed in the resistant lines regarding the parental one. -
Updates in Ocular Antifungal Pharmacotherapy: Formulation and Clinical Perspectives
Current Fungal Infection Reports (2019) 13:45–58 https://doi.org/10.1007/s12281-019-00338-6 PHARMACOLOGY AND PHARMACODYNAMICS OF ANTIFUNGAL AGENTS (N BEYDA, SECTION EDITOR) Updates in Ocular Antifungal Pharmacotherapy: Formulation and Clinical Perspectives Ruchi Thakkar1,2 & Akash Patil1,2 & Tabish Mehraj1,2 & Narendar Dudhipala1,2 & Soumyajit Majumdar1,2 Published online: 2 May 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Purpose of Review In this review, a compilation on the current antifungal pharmacotherapy is discussed, with emphases on the updates in the formulation and clinical approaches of the routinely used antifungal drugs in ocular therapy. Recent Findings Natamycin (Natacyn® eye drops) remains the only approved medication in the management of ocular fungal infections. This monotherapy shows therapeutic outcomes in superficial ocular fungal infections, but in case of deep-seated mycoses or endophthalmitis, successful therapeutic outcomes are infrequent, as a result of which alternative therapies are sought. In such cases, amphotericin B, azoles, and echinocandins are used off-label, either in combination with natamycin or with each other (frequently) or as standalone monotherapies, and have provided effective therapeutic outcomes. Summary In recent times, amphotericin B, azoles, and echinocandins have come to occupy an important niche in ocular antifungal pharmacotherapy, along with natamycin (still the preferred choice in most clinical cases), in the management of ocular fungal infections. -
Natamycin Ophthalmic Suspension)5% Sterile
NDA 50-514/S-009 Page 3 Natacyn® (natamycin ophthalmic suspension)5% Sterile DESCRIPTION: NATACYN® (natamycin ophthalmic suspension) 5% is a sterile, antifungal drug for topical ophthalmic administration. Each mL of the suspension contains: Active: natamycin 5% (50mg). Preservative: benzalkonium chloride 0.02%. Inactive: sodium hydroxide and/or hydrochloric acid (neutralized to adjust the pH), purified water. The active ingredient is represented by the chemical structure: Established name: Natamycin Chemical Structure Molecular Formula: C33H47NO13 Molecular Weight: 665.73 Chemical name: Stereoisomer of 22-[(3-amino-3,6-dideoxy- β-D-mannopyranosyl)oxy]-1,3,26 trihydroxy-12- methyl-10-oxo-6,11,28- trioxatricyclo[22.3.1.05,7] octacosa-8,14,16,18,20-pentaene-25-carboxylic acid. Other: Pimaricin The pH range is 5.0 – 7.5. CLINICAL PHARMACOLOGY: Natamycin is a tetraene polyene antibiotic derived from Streptomyces natalensis. It possesses in vitro activity against a variety of yeast and filamentous fungi, including Candida, Aspergillus, Cephalosporium, Fusarium and Penicillium. The mechanism of action appears to be through binding of the molecule to the sterol moiety of the fungal cell membrane. The polyenesterol complex alters the permeability of the membrane to produce depletion of essential cellular constituents. Although the activity against fungi is dose-related, natamycin is predominantly fungicidal.* Natamycin is not effective in vitro against gram-positive or gram-negative bacteria. Topical administration appears to produce effective concentrations of natamycin within the corneal stroma but not in intraocular fluid. Systemic absorption should not be expected following topical administration of NATACYN® (natamycin ophthalmic suspension) 5%. As with other polyene antibiotics, absorption from the gastrointestinal tract is very poor. -
First-Line Treatment of Oral Candidiasis in Adults
No. 628017 First-line Treatment of Oral Candidiasis in Adults Developed in collaboration with an advisory committee consisting of Québec clinicians and experts. Validated by the Comité d’excellence clinique en usage optimal du médicament, des protocoles médicaux nationaux et ordonnances of the Institut national d’excellence en santé et en services sociaux (INESSS). CLINICAL SITUATION OR TARGET POPULATION Person aged 18 years and older with one or several of the following clinical signs and symptoms: ► Sensation of burning, discomfort or general pain in the mouth or at the corners of the mouth, which worsens when eating food1 ► White patches that can be scraped away more or less easily; redness on the mucous membranes of the mouth. ► Cracked skin or slight bleeding at the corners of the mouth, which may extend to marionette lines. ► Total or partial loss of papillae on the surface of the tongue. CONTRAINDICATIONS TO THE APPLICATION OF THIS PROTOCOL ► Contraindication or history of allergic reaction to the recommended medication. ► Known case of refractory oral candidiasis. ► Oral candidiasis recurrence within one month of initial treatment. ► White patches that appear unilaterally on the tongue or cannot be scraped away. ► Bite or sore marks on the inside of the cheeks or on the tongue. ► Gum or submaxillary swelling. ► Surgery, injury, trauma, cut, burns in the mouth, or oral health problems (e.g. viral, bacterial or fungal infections) within the past two (2) weeks. ► Oral pain, localized or unilateral. ► Difficulty in swallowing, pain or burning sensation in the sternum or chest (suggesting esophageal candidiasis). ► Constant burning sensation that lessens when eating food (suggesting stomatopyrosis).