Systemic antimycotics

Systematic nomenclature Systemic antimycotics Systhane Syzygiol Szaibelyite... 

Amphotericin B. Amphotericin B (3), an important polyene antibiotic, is administered almost exclusively via the intravenous route and is therefore discussed in more detail under the systemic antimycotics. The vaginal tablets contain 50 mg amphotericin B, and 100 mg tetracycline base per tablet (see also Antibiotics, tetracyclines). The tablets for oral use contain 50 mg amphotericin B, 250 mg tetracycline base, and 125 mg sodium hexametaphosphate. A combination ointment contains 1 mg fludrocortisone acetate, 2.5 mg neomycin, 0.25 mg gramicidin, and 1 g plastibase in addition to 30 mg amphotericin B (see also Antibiotics, peptides). 

Varhe, A., Olkkolam, K.T., and Neuvonen, P.J. (1994) Pharmacokinetics and drug disposion oral triazolam is potentially hazardous to patients receiving systemic antimycotics ketoconazole or itraconazole. Clin Pharmacol Ther 56 601—607. 

Olkkola KT, Ahonen J, Neuvonen PJ. The effect of systemic antimycotics, itraconazole and fluconazole, on the pharmacokinetics and pharmacodynamics of intravenous and oral midazolam. Anesth Analg 1996 82 511-516. 

Viudes A, Peman J, Canton E, et al The activity of combinations of systemic antimycotic drugs. Rev Esp... 

Olkkola KT, Backman JT, Neuvonen PJ. Mida lam should be avoided in patients receiving systemic antimycotics ketoconazole or itracona le. ClinPharmacol Ther ( 994) 55,481-5. 

The P. are structurally related to echinocandin B and, like the latter, represent important lead structures for the discovery of new, systemic antimycotic agents. They act as inhibitors of fungal l,3-)5-D-glucan syn-... 

Piadhnlcins. A group of 20 currently known anthra-cyclinone antibiotics with antimycotic and antiviral activity isolated from various Actinomadura strains (Ac-tinomycetes) e. g., P. A (N-methylbenanomycin B) C4oI N20,8, Mr 840.79, red cryst., mp. 193- I95°(T, [a]o +685° (0.1 m HCI), solubility in HjO 17 mg/L, LD50 (mouse i. v.) 120 mg/kg. The P. are related to the benanomycins, and are in some cases identical. Clinical development of a P. derivative as a systemic antimycotic was started in 1996 but has now been abandoned because of efficacy and tolerance problems. 

Treatment of dermatophytoses is nowadays straightforward. The topical agents, including various imidazoles (econazole, tioconazole, isoconazole, bifonazole, etc.) are equally efficient and can be used in all forms of dermatophytosis except onychomycosis (due to lack of penetration). One daily application is considered adequate for 2-4 weeks. There is a tendency to use simultaneously systemic antimycotics, even in tinea corporis, when multiple lesions are present. 

Fungal infections from animals are mostly on open skin areas. Infections by T. verrucosum or T. equinum for example, often result in deep follicular infections (kerion celsi) and are often misdiagnosed as bacterial infections. Children seem to be more susceptible to T. verrucosum than adults. Their skin lesions are often on the face or head. The deeper forms of fungal infections can be quite long standing, even feverish, and may leave permanent scars. Systemic, antimycotic treatment is often warranted in these cases. Zoophilic fungi may be difficult to culture e.g., T, verrucosum has its own specific cultural demands. 

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