Antimycotic

To mycologists, each fungal infection has something specific, either in its symptomatology or its etiology. However, this is less obvious to practitioners. The incidence and the severity of the pathology are sometimes underestimated. Mycoses may be classified as follows  

Oral treatment offers the advantage of bringing all the lesions at all sites under control, in addition to the absence of unpleasant cosmetic effects. In certain cases, it may be preferable to use oral treatment for C. albicans vaginitis and for extensive and persistent pityriasis versicolor, a skin disorder caused by Pityrosporum orbiculare. In the case of onychomycosis, a combination treatment, topical plus systemic, is required. It is preferable to use oral treatment for deep and systemic mycoses, though intravenous or intrathecal treatment is sometimes required. 

The final choice of a suitable antimycotic and the route of adniinistration are deterrnined by many factors safety of the antimycotic, easy adniinistration, broad-spectmm activity, and rapid clinical improvement associated with mycological cure. 

Older Compounds. Some antimycotics have been used for a long time Whitfield s ointment is a typical example (1907). The ointment usually contains 6% ben2oic acid [65-85-0] and 3% sahcyhc acid [69-72-7] C H O. The action is attributed to the keratolytic effect of the sahcyhc acid 

The main advantage of this ointment is its low price. This combination has now been replaced by more active modern antimycotics. Long ago, the antimycotic effect of aUphatic carboxyUc acids with an increasing number of C-atoms was discovered. The optimum is 11 C-atoms and CH2=CH(CH2)gCOOH, undecylenic acid [112-38-9] C22H2QO2, is used in several ointments. 

Superficial dermatophyto sis trichophytosis microsporosis epidermophyto sis pityriasis candidosis 

The physician must decide whether to opt for systemic or topical treatment and which arguments will convince the patient to use one or both forms for the minimum period recommended. It is typical for mycoses that the period of treatment generally exceeds one week and may even last a few months. There is still a strong tendency to treat the organ or the part of the organ affected by the pathogenic microorganism. This is justifiable in the case of localized unifocal mycoses of the skin caused by dermatophytes. 

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