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Dermatologie (Heidelberg, Germany) Jun 2024Topical antifungals with activity against dermatophytes include amorolfine, allylamines, azoles, ciclopiroxolamine, and tolnaftate. Polyene antimycotics, such as...
Topical antifungals with activity against dermatophytes include amorolfine, allylamines, azoles, ciclopiroxolamine, and tolnaftate. Polyene antimycotics, such as amphotericin B and nystatin, alternatively, miconazole are suitable for yeast infections of the skin and mucous membranes. For severe yeast infections of the skin and mucous membranes, oral triazole antimycotics, such as fluconazole and itraconazole, are used. Pityriasis versicolor is treated topically with antimycotics, and in severe forms also orally with itraconazole, alternatively fluconazole. Terbinafine, itraconazole and fluconazole are currently available for the systemic treatment of severe dermatophytoses, tinea capitis and onychomycosis. In addition to proven therapeutic regimens, unapproved (off-label use) intermittent low-dose therapies are increasingly being used, particularly in onychomycosis. Oral antimycotics for the treatment of tinea capitis and onychomycosis in children and adolescents can only be used off-label in Germany. In general, any oral antifungal treatment should always be combined with topical antifungal therapy. In tinea corporis and tinea cruris caused by Trichophyton (T.) mentagrophytes ITS (internal transcribed spacer) genotype VIII (T. indotineae), there is usually terbinafine resistance. Identification of the species and genotype of the dermatophyte and resistance testing are required. The drug of choice for T. mentagrophytes ITS genotype VIII dermatophytoses is itraconazole. In individual cases, treatment-refractory onychomycosis may be due to terbinafine resistance of T. rubrum. Here too, resistance testing and alternative treatment with itraconazole should be considered. Therapy monitoring should be carried out culturally and, if possible, using molecular methods (polymerase chain reaction). Alternative treatment options include laser application, and photodynamic therapy (PDT).
PubMed: 38874607
DOI: 10.1007/s00105-024-05359-y -
Journal of Xenobiotics Jul 2023Vulvovaginitis with spp. is the most common infection in women and the rate is increased during pregnancy. Antifungal prescription in pregnant women continues to...
Vulvovaginitis with spp. is the most common infection in women and the rate is increased during pregnancy. Antifungal prescription in pregnant women continues to present challenges and the decision must balance the risk of fetal toxicity with the benefits to the fetus and mother. Starting from the idea that clotrimazole is the most recommended antifungal in candidal vaginitis in pregnancy, we tested the sensitivity of different species of spp. to other azoles, polyenes, and antimetabolites. This retrospective study (January to June 2019) assessed 663 pregnant women hospitalized for various pregnancy-related symptoms in which samples of phage secretion were taken. The laboratory results confirmed 21% of cases, indicating 140 positive mycologic samples. In this study, vaginal candidiasis was mostly related to the first trimester of pregnancy (53.57%,) and less related in the last trimester (17.14%). was the most frequent isolated strain in this study, accounting for 118 cases, followed by 16 strains of and 6 cases of . The highest sensitivity for was found in azoles, mostly in miconazole (93.2%), while was completely resistant to polyene with low sensitivity in antimetabolites and even in some azoles, such as fluconazole. In our study, higher resistance rates to flucytosine were found, with and exhibiting greater resistance than .
PubMed: 37489336
DOI: 10.3390/jox13030023 -
International Journal of Molecular... Mar 2024Miconazole is an antimycotic drug showing anti-cancer effects in several cancers. However, little is known on its effects in melanoma. A375 and SK-MEL-28 human melanoma...
Miconazole is an antimycotic drug showing anti-cancer effects in several cancers. However, little is known on its effects in melanoma. A375 and SK-MEL-28 human melanoma cell lines were exposed to miconazole and clotrimazole (up to 100 mM). Proliferation, viability with MTT assay and vascular mimicry were assayed at 24 h treatment. Molecular effects were measured at 6 h, namely, ATP-, ROS-release and mitochondria-related cytofluorescence. A metabolomic profile was also investigated at 6 h treatment. Carnitine was one of the most affected metabolites; therefore, the expression of 29 genes involved in carnitine metabolism was investigated in the public platform GEPIA2 on 461 melanoma patients and 558 controls. After 24 h treatments, miconazole and clotrimazole strongly and significantly inhibited proliferation in the presence of 10% serum on either melanoma cell lines; they also strongly reduced viability and vascular mimicry. After 6 h treatment, ATP reduction and ROS increase were observed, as well as a significant reduction in mitochondria-related fluorescence. Further, in A375, miconazole strongly and significantly altered expression of several metabolites including carnitines, phosphatidyl-cholines, all amino acids and several other small molecules, mostly metabolized in mitochondria. The expression of 12 genes involved in carnitine metabolism was found significantly modified in melanoma patients, 6 showing a significant impact on patients' survival. Finally, miconazole antiproliferation activity on A375 was found completely abrogated in the presence of carnitine, supporting a specific role of carnitine in melanoma protection toward miconazole effect, and was significantly reversed in the presence of caspases inhibitors such as ZVAD-FMK and Ac-DEVD-CHO, and a clear pro-apoptotic effect was observed in miconazole-treated cells, by FACS analysis of Annexin V-FITC stained cells. Miconazole strongly affects proliferation and other biological features in two human melanoma cell lines, as well as mitochondria-related functions such as ATP- and ROS-release, and the expression of several metabolites is largely dependent on mitochondria function. Miconazole, likely acting via carnitine and mitochondria-dependent apoptosis, is therefore suggested as a candidate for further investigations in melanoma treatments.
Topics: Humans; Melanoma; Miconazole; Clotrimazole; Reactive Oxygen Species; Mitochondria; Carnitine; Adenosine Triphosphate
PubMed: 38612401
DOI: 10.3390/ijms25073589 -
BMC Oral Health Oct 2023To evaluate the clinical efficacy of photodynamic therapy (PDT) as an adjunct or alternative to traditional antifungal drugs in the treatment of oral candidiasis, and to... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To evaluate the clinical efficacy of photodynamic therapy (PDT) as an adjunct or alternative to traditional antifungal drugs in the treatment of oral candidiasis, and to provide evidence-based medical evidence for its use in the treatment of oral candidiasis.
METHODS
Computer combined with manual retrieval of China Academic Journals Full-text Database (CNKI), China Biomedical Literature Database (CBM), Chinese Science and Technology Journal Database (VIP), Wanfang Database, PubMed, Web of Science, Cochrane Library, Embase, Scopus retrieval for articles published before January 2023, basic information and required data were extracted according to the inclusion and exclusion criteria, and the Revman V5.4 software was used to conduct Meta-analysis of the included literature.
RESULTS
A total of 11 articles were included, 7 of which used nystatin as an antifungal drug, 2 of which were combined treatment of PDT and nystatin, 2 of the remaining 4 articles were treated with fluconazole, and 2 were treated with miconazole. Meta results showed that PDT was superior to nystatin in reducing the number of oral candida colonies in the palate of patients MD = -0.87, 95%CI = (-1.52,-0.23), P = 0.008, the difference was statistically significant, and the denture site MD = -1.03, 95%CI = (-2.21, -0.15), P = 0.09, the difference was not statistically significant; compared with the efficacy of fluconazole, RR = 1.01, 95%CI = (0.56,1.83), P = 0.96; compared with miconazole RR = 0.55, 95%CI = (0.38, 0.81), P = 0.002; PDT combined with nystatin RR = 1.27, 95%CI = (1.06, 1.52), P = 0.01; recurrence rate RR = 0.28, 95%CI = (0.09, 0.88), P = 0.03.
CONCLUSIONS
PDT was effective in the treatment of oral candidiasis; PDT was more effective than nystatin for the treatment of denture stomatitis in the palate, while there was no significant difference between the two for the denture site; The efficacy of PDT for oral candidiasis was similar to that of fluconazole; PDT was less effective than miconazole for oral candidiasis; Compared with nystatin alone, the combination of PDT and nystatin is more effective in treating oral candidiasis with less risk of recurrence.
Topics: Humans; Candidiasis, Oral; Antifungal Agents; Nystatin; Fluconazole; Miconazole; Photochemotherapy
PubMed: 37884914
DOI: 10.1186/s12903-023-03484-z -
The Journal of Prosthetic Dentistry Jan 2024Gel formulations containing antimicrobials are a potential alternative for the development of new medicines for the treatment of denture stomatitis (DS). However,... (Review)
Review
STATEMENT OF PROBLEM
Gel formulations containing antimicrobials are a potential alternative for the development of new medicines for the treatment of denture stomatitis (DS). However, whether they are more effective than antifungal drugs is unclear.
PURPOSE
The purpose of this systematic review was to identify whether gels formulated with antimicrobial substances are more effective and biocompatible for the treatment of DS than antifungal drugs.
MATERIAL AND METHODS
This systematic review was structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022379510). Searches were performed in the PubMed, Lilacs, Web of Science, Scopus, Embase, and Google Scholar databases in November 2022. Randomized and nonrandomized clinical trials comparing the efficacy of experimental gels and conventional antifungals in the treatment of DS were included.
RESULTS
Gels formulated with Zataria multiflora essential oil and clove and cinnamon extracts showed higher antimicrobial efficacy compared with miconazole and clotrimazole. Formulations containing Uncaria tomentosa, Punica granatum, and propolis extract showed similar efficacy to nystatin and miconazole. Two formulations containing P. granatum were less effective than nystatin and miconazole. Gels of Z. multiflora and miconazole induced adverse effects including burning, itching, nausea, and vomiting. The included studies did not evaluate the biocompatibility of the gels.
CONCLUSIONS
Gels formulated with natural antimicrobials such as Z. multiflora, U. tomentosa, P. granatum, propolis, and clove and cinnamon showed higher or similar antimicrobial efficacy to conventional antifungals in the treatment of DS. The biocompatibility of experimental gels based on natural agents should be evaluated.
PubMed: 38195253
DOI: 10.1016/j.prosdent.2023.12.014 -
Asian Pacific Journal of Allergy and... Dec 2023Allergic reaction to topical drugs varies depending on use and availability of topical drugs and self-medication.
BACKGROUND
Allergic reaction to topical drugs varies depending on use and availability of topical drugs and self-medication.
OBJECTIVE
We aimed to determine the incidence of contact dermatitis to topical medicaments among patients referred for patch testing.
METHODS
All patients with suspected allergic contact dermatitis were patch tested with standard and medicament series. The characterization was performed according to the MOAHLFA index.
RESULTS
59/215 (27.4%) patients had positive reactions to at least 1 medicament but only 13/59 (22.0%) had a relevant history. The 3 most common positive medicaments were framycetin 23/215 (10.7%), miconazole 22/215 (10.2%), and econazole 17/215 (7.9%). Among those positive to medicament, face was the most common location 22/59 (37.3%). 39/215 (18.1%) had more than 2 co-positive standard allergens and showed significant higher rate of topical medicament sensitization. The contributing factors of medicament allergy were the history of suspected allergens in personal care products (OR = 2.09, P = 0.038), topical drugs (OR = 2.93, P = 0.002), topical treatment (OR = 2.47, P = 0.011), and history of drug allergy (OR = 1.78, P = 0.023).
CONCLUSIONS
The study showed a high rate of medicament sensitization especially antibiotic and antifungal drugs. The incidence of positive medicament patch test result was associated with facial dermatitis. Polysensitization and history of previous exposure, either as treatment or overusing of drugs, significantly associated with medicament positive patients. This study supports the inclusion of medicaments within the standard series of patch test.
Topics: Humans; Dermatitis, Allergic Contact; Allergens; Anti-Bacterial Agents; Administration, Topical; Antifungal Agents; Drug Hypersensitivity; Patch Tests; Retrospective Studies
PubMed: 33274954
DOI: 10.12932/AP-180820-0944 -
Environmental Science & Technology Dec 2023The ubiquitous presence of pharmaceuticals and personal care products (PPCPs) in environments has aroused global concerns; however, minimal information is available...
The ubiquitous presence of pharmaceuticals and personal care products (PPCPs) in environments has aroused global concerns; however, minimal information is available regarding their multimedia distribution, bioaccumulation, and trophic transfer in marine environments. Herein, we analyzed 77 representative PPCPs in samples of surface and bottom seawater, surface sediments, and benthic biota from the Bohai Sea. PPCPs were pervasively detected in seawater, sediments, and benthic biota, with antioxidants being the most abundant PPCPs. PPCP concentrations positively correlated between the surface and bottom water with a decreasing trend from the coast to the central oceans. Higher PPCP concentrations in sediment were found in the Yellow River estuary, and the variations in the physicochemical properties of PPCPs and sediment produced a different distribution pattern of PPCPs in sediment from seawater. The log , but not log , showed a linear and positive relationship with bioaccumulation and trophic magnification factors and a parabolic relationship with biota-sediment accumulation factors. The trophodynamics of miconazole and acetophenone are reported for the first time. This study provides novel insights into the multimedia distribution and biomagnification potential of PPCPs and suggests that log is a better indicator of their bioaccumulation and trophic magnification.
Topics: Water Pollutants, Chemical; Environmental Monitoring; Seawater; Cosmetics; Pharmaceutical Preparations; China
PubMed: 38078887
DOI: 10.1021/acs.est.3c06522 -
Skinmed 2024A healthy 32-year-old woman presented to clinic with tender pruritic lesions of 2-month duration at the vulva and lesions for weeks on the shins. She was treated with...
A healthy 32-year-old woman presented to clinic with tender pruritic lesions of 2-month duration at the vulva and lesions for weeks on the shins. She was treated with topical corticosteroids and intravenous vancomycin without significant improvement. On examination, dozens of follicular hemorrhagic papulopustules were detected at the suprapubic area and vulva (Figure 1). Similar but less prominent lesions were observed on the shins as well. Biopsies of the vulva and shin revealed a follicular inflammatory infiltrate of neutrophils, histiocytes, and lymphocytes as well as fungal hyphae within the follicular infundibulum and hair shafts, consistent with Majocchi's granuloma (MG). Gram and Fite-Faraco staining, direct immunofluorescence, and bacterial culture were negative. Tissue culture grew , which was identified using sequence analysis of the D1/D2 region of the 28s rDNA. Minimum inhibitory concentrations for terbinafine, ketoconazole, and itraconazole were determined, with terbinafine having the lowest concentration. Additional history revealed that shortly prior to commencement of her clinical manifestations, the patient had acquired a pet guinea pig with eruptions and hair loss (Figure 2). The patient was prescribed ketoconazole cream and terbinafine, 250 mg daily, with almost immediate improvement. Based on clinical response, the patient remained on terbinafine and ketoconazole cream for 6 months. Her skin remained clear 4 months after discontinuing all antifungals. Based on the results of patient's culture, a veterinarian treated her guinea pig successfully with systemic terbinafine and miconazole lotion.
Topics: Female; Humans; Animals; Guinea Pigs; Adult; Terbinafine; Ketoconazole; Trichophyton; Antifungal Agents; Vulva; Tinea
PubMed: 38494619
DOI: No ID Found -
Resurgence and Repurposing of Antifungal Azoles by Transition Metal Coordination for Drug Discovery.Pharmaceutics Sep 2023Coordination compounds featuring one or more antifungal azole (AA) ligands constitute an interesting family of candidate molecules, given their medicinal polyvalence and... (Review)
Review
Coordination compounds featuring one or more antifungal azole (AA) ligands constitute an interesting family of candidate molecules, given their medicinal polyvalence and the viability of drug complexation as a strategy to improve and repurpose available medications. This review reports the work performed in the field of coordination derivatives of AAs synthesized for medical purposes by discussing the corresponding publications and emphasizing the most promising compounds discovered so far. The resulting overview highlights the efficiency of AAs and their metallic species, as well as the potential still lying in this research area.
PubMed: 37896159
DOI: 10.3390/pharmaceutics15102398 -
3 Biotech Nov 2023The ineffectiveness of azole drugs in treating Vulvovaginal Candidiasis (VVC) and Recurrent Vulvovaginal Candidiasis (RVVC) due to antifungal resistance of non-albicans...
The ineffectiveness of azole drugs in treating Vulvovaginal Candidiasis (VVC) and Recurrent Vulvovaginal Candidiasis (RVVC) due to antifungal resistance of non-albicans Candida has led to the investigation of inorganic nanoparticles with biological activity. Silver nanoparticles (AgNPs) are important in nanomedicine and have been used in various products and technologies. This study aimed to develop a vaginal cream and assess its in vitro antimicrobial activity against strains, specifically focusing on the synergy between AgNPs and miconazole. AgNPs were synthesized using glucose as a reducing agent and sodium dodecyl sulfate (SDS) as a stabilizer in varying amounts (0.50, 0.25, and 0.10 g). The AgNPs were characterized using UV-Visible (UV-Vis) and Fourier-Transform Infrared (FT-IR) spectroscopies, X-Ray Diffraction (XRD), Dynamic Light Scattering (DLS), Scanning Electron Microscopy (SEM), and Energy Dispersive X-Ray Analysis (EDX). Fifty strains of were used to evaluate the synergistic activity. AgNPs synthesized with 0.5 g SDS had an average size of 77.58 nm and a zeta potential of -49.2 mV, while AgNPs with 0.25 g showed 91.22 nm and -47.2 mV, respectively. AgNPs stabilized with 0.1 g of SDS were not effective. When combined with miconazole, AgNPs exhibited significant antifungal activity, resulting in an average increase of 80% in inhibition zones. The cream developed in this study, containing half the miconazole concentration of commercially available medication, demonstrated larger inhibition zones compared to the commercial samples.
PubMed: 37810191
DOI: 10.1007/s13205-023-03776-9