The significance of itraconazole for treatment of fungal infections of skin, nails and mucous membranes

Abstract

Itraconazole is an antifungal drug from the triazole group with distinct in vitro activity against dermatophytes, yeasts and some molds. Itraconazole has a primarily fungistatic activity. Itraconazole accumulates in the stratum corneum and in nail material due to its high affinity to keratin, as well as in sebum and vaginal mucosa. Together with terbinafine and fluconazole, itraconazole belongs to the modern highly effective systemic antifungal drugs with a favorable risk-benefit ratio and for this reason is a preferred therapy option for fungal infections of skin, nails and mucous membranes. Compared to terbinafine in the treatment of fingernail and toenail fungal infections, itraconazole offers the advantage of a broad antifungal spectrum and better effectiveness against onychomycosis caused by yeasts yet appears inferior with regard to the more common dermatophyte infections. Itraconazole constitutes an important therapy option, along with fluconazole, terbinafine, ketoconazole and griseofulvin, for the treatment of dermatophyte infections of glabrous skin (tinea pedis, tinea manuum, tinea corporis and tinea cruris) in adults following unsuccessful topical therapy. In the oral therapy of tinea capitis, itraconazole plays an especially important role, in particular for disease caused by Microsporum canis (for children, however, only off-label use is feasible currently). In the treatment of oropharyngeal candidiasis, candidiasis of the skin and vulvovaginal candidiasis, itraconazole and fluconazole are the preferred treatment options in cases in which topical therapy has proven unsuccessful.

Dysfunctional cardiac mitochondrial bioenergetic, lipidomic, and signaling in a murine model of Barth syndrome

“…Tetracyclines, including doxycycline, have previously been associated with modulation of secretory phospholipases ( 84,85 ) as well as the inhibition of metalloproteinases, downregulation of cytokines, and cell proliferation ( 86 ), all of which should be considered in regard to the phenotypic characterization of the Barth syndrome mouse model. Because the inducible Taz KD mice were compared with wild-type age-matched littermates also fed a doxycycline-enriched diet, the differential phenotype displayed represents the pathological changes induced by cardiac myocyte tafazzin defi ciency.…”

“…Because the inducible Taz KD mice were compared with wild-type age-matched littermates also fed a doxycycline-enriched diet, the differential phenotype displayed represents the pathological changes induced by cardiac myocyte tafazzin defi ciency. Furthermore, it was previously reported that the level at which doxycycline or tetracyclines inhibited these biological processes in vitro far exceeds the pharmacological dose that would be administered in vivo ( 86,87 ), thus demonstrating the strength of the pathological fi ndings manifest during tafazzin defi ciency that are reversible upon its reexpression.…”

Safety and Tolerability of Luliconazole Solution 10-Percent in Patients with Moderate to Severe Distal Subungual Onychomycosis

“…The MIC of luliconazole (MIC 90 ) has been found to be 4-to 1,000-fold lower than the MIC 90 s reported for a number of antifungals, including terbinafine, bifonazole, and lanoconazole (12,(14)(15)(16). Luliconazole is also more potent in vitro than terbinafine and bifonazole in inhibiting C. albicans (14).…”

“…On each of these days, blood was collected immediately prior to dosing and then at 1,3,6,9,12,16,20, and 24 h after dosing. Additional blood draws were conducted prior to dosing on days 3, 4, 5, 11, 18, 22, and 25 and following the cessation of treatment on days 31, 32, 33, and 36 (the last study visit, which occurred 7 days after the last treatment application).…”

Criptococose cutânea associada à severa infestação por Sarcoptes sp. e Demodex sp. em um cão

“…O itraconazol é efi caz no tratamento de uma grande variedade de micoses superfi ciais, por se acumular nos ceratinócitos e atingir altas concentrações na secreção sebácea e nos pelos (KORTING & SCHÖLLMANN, 2009).…”