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Systemic antifungal therapy
M Moossavi1, B Bagheri, R K Scher
1Department of Dermatology, Columbia University College of Physicians and Surgeons, New York City, New York, USA.
Dermatologic Clinics
|January 13, 2001
Summary
Systemic antifungal treatments for fungal skin infections have evolved significantly. While newer drugs offer broader effectiveness and shorter treatment times, the ideal oral antifungal agent remains elusive, necessitating continued research.
Area of Science:
- Dermatology
- Pharmacology
- Infectious Diseases
Background:
- Systemic antifungal therapy for superficial mycoses has seen major advancements since 1958.
- The development of azole antifungals (ketoconazole, itraconazole, fluconazole) expanded treatment options and reduced duration.
- Terbinafine offers a unique mechanism of action with potent fungicidal properties.
Purpose of the Study:
- To review the advancements in systemic antifungal therapy for superficial mycoses.
- To discuss the pharmacological properties, clinical use, and cost-effectiveness of available oral antifungal agents.
- To highlight the ongoing need for novel antifungal drug development.
Main Methods:
- Literature review of systemic antifungal agents for superficial mycoses.
- Pharmacological profile analysis of griseofulvin, azoles, and terbinafine.
- Discussion of clinical application, treatment selection criteria, and cost considerations.
Main Results:
- Griseofulvin marked the beginning of systemic antifungal therapy.
- Azoles provided broader spectrum and shorter treatment durations.
- Terbinafine exhibits unique fungicidal activity.
Conclusions:
- Selecting the appropriate oral antifungal requires integrating pharmacological knowledge, clinical experience, and cost-effectiveness.
- None of the currently available five oral antifungal drugs meet the criteria for an "ideal" antifungal agent.
- Continued research is essential to discover new oral antifungal medications with improved profiles.