Current Trends in the Use of Two Combination Antifungal/Corticosteroid Creams

Wheat, Chikoti M.; Bickley, Ryan J.; Hsueh, Yu Han; Cohen, Bernard A.

doi:10.1016/j.jpeds.2017.03.031

Cited by 11 publications

(11 citation statements)

References 9 publications

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“…10,11 Many primary care physicians prescribe topical steroids for ringworm-despite the recommendations not to use them. [12][13][14] Our observational study found that prior use with topical steroids-compared with local administration of antifungal agentswas associated with lower odds of complete or clinical cure for tinea capitis; hence, our finding substantiates the recommendation to not use topical steroids for this indication. The worsening of fungal infections could be a result of steroids' ability to suppress the skin's immunity.…”

Section: Discussionsupporting

confidence: 74%

Management of tinea capitis in Israel: A comparative study

Shemer

Gupta

Galili

et al. 2021

Pediatric Dermatology

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Tinea capitis is a dermatophyte infection of the scalp and hair structures; this condition can be managed with various oral antifungal agents. 1 The predominant pathogen varies according to geographical region. In Israel, there have been a growing number of cases caused by Trichophyton tonsurans, and this finding contrasts with historical observations: Between 1954 and 1978, the majority of cases in Israel were culture positive for Trichophyton violaceum. [2][3][4] A recent network meta-analysis study found that oral terbinafine is the most efficacious systemic treatment for tinea capitis to produce complete and mycological cure. 1 We hypothesized that patients' likelihood of complete or clinical cure for tinea capitis caused by the Trichophyton species is greater with oral terbinafine therapy,

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Section: Discussionsupporting

confidence: 74%

Management of tinea capitis in Israel: A comparative study

Shemer

Gupta

Galili

et al. 2021

Pediatric Dermatology

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“…When compared to the antifungal activity of antibiotics reported by Banfalvi ( 2020 ), M. gypseum was more susceptible to gentamicin B1 (MIC 3.1 µg/mL). However, evidence shows antifungal topicals are more expensive when used in combination with corticosteroid and less effective as single-agent antifungals (Wheat et al 2017 ). Therefore, the synergistic potential of the test plant extracts with topical antifungals that are already in medical use, makes it a promising alternative for antifungal therapy.…”

Section: Discussionmentioning

confidence: 99%

In vitro antidermatophytic activity of bioactive compounds from selected medicinal plants

2021

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Fungal infections are among the most difficult diseases to manage in humans. Eukaryotic fungal pathogens share many similarities with their host cells, which impairs the development of antifungal compounds. Therefore, it is desirable to harness the pharmaceutical potential of medicinal plants for antifungal drug discovery. In this study, the antifungal activity of sixteen plant extracts was investigated against selected dermatophytic fungi. Of the sixteen plants, the cladode (leaf) of Asparagus racemosus, and seed extract of Cassia occidentalis showed antifungal activity against Microsporum gypseum, Microsporum nanum, Trichophyton mentagrophytes and Trichophyton terrestre. The plant antifungal compounds were located by direct bioassay against Cladosporium herbarum. IR and NMR spectrometry analyses of these compounds identified the presence of saponin (in A. racemosus) and hydroxy anthraquinone (in C. occidentalis) in these antifungal compounds. The antidermatophytic activity of plant anthraquinone and saponins with reports of little or no hemolytic activity, makes these compounds ideal for alternative antifungal therapy and warrants further in-depth investigation in vivo.

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“…Although product monographs for combination products typically advise against their use in intertriginous folds, 9 the high potency of steroids in these prescriptions is often underappreciated by providers. 15,16 Finally, combination agents are typically more expensive than monotherapy alone, 15 which creates unnecessary financial burden for patients.…”

Section: Recommendation #2: Don't Routinely Prescribe Combination Cormentioning

confidence: 99%

The Canadian Dermatology Association’s Top Five Choosing Wisely Canada Recommendations

Zhou

Nurmohamed

et al. 2020

J Cutan Med Surg

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Introduction In this article, we present the Canadian Dermatology Association’s (CDA) Choosing Wisely Canada (CWC) list of top “Five Things Physicians and Patients Should Question in Dermatology” and the evidence in support of each recommendation. Methods Using a nominal technique, the CDA Working Group and Task Force generated an initial list based on literature review and expert consultation. After several rounds of list refinement via a modified Delphi process, a final list of recommendations was generated. These were approved by the CDA Board of Directors, presented at the CDA 93rd Annual Conference in 2018, and published by CWC in 2019. Results The top five recommendations are as follows: (1) Don’t routinely prescribe antibiotics for bilateral lower leg redness and swelling; (2) Don’t routinely prescribe topical combination corticosteroid/antifungal products; (3) Don’t routinely use topical antibiotics on a surgical wound; (4) Don’t prescribe systemic antifungals without mycological confirmation of dermatophyte infection; and (5) Don’t use oral antibiotics for acne vulgaris for more than 3 months without assessing efficacy. Discussion This list of recommendations aims to encourage both physicians and patients to reevaluate ineffective, yet common, practices in treating dermatologic conditions. These recommendations represent actionable changes in practice, and therefore have considerable potential to enhance value-based care in dermatology. Conclusions This list was developed to identify tangible changes in practice within dermatology that may reduce inefficiencies, prevent potential patient harm, and improve care. Future advocacy work may include updates, feedback obtainment, and patient care handouts, to continue to promote value-based healthcare and best practices.

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Current Trends in the Use of Two Combination Antifungal/Corticosteroid Creams

Cited by 11 publications

References 9 publications

Management of tinea capitis in Israel: A comparative study

Management of tinea capitis in Israel: A comparative study

In vitro antidermatophytic activity of bioactive compounds from selected medicinal plants

The Canadian Dermatology Association’s Top Five Choosing Wisely Canada Recommendations

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