RESUMO
Abstract Introduction: Otomycosis, an infection of the ear canal by fungi, is prevalent in hot and humid weather. Nevertheless, there is not sufficient evidence for the effectiveness of different topical antifungal treatments. Tolnaftate, is a topical antifungal agent described to be effective in the treatment of otomycosis. Currently there are not sufficient studies that prove its efficacy. Objectives: To compare the efficacy of clotrimazole and tolnaftate administration in the treatment of otomycosis. Material and methods: A controlled, randomized and open clinical trial included patients diagnosed with fungal external otitis who were treated with topical antifungals, randomized into two treatment groups: (1) clotrimazole cream; (2) tolnaftate solution. They were microscopically evaluated at one and two weeks of treatment to determine resolution of disease. Recurrence and complications were recorded. Demographic and clinical variables were collected and analyzed. Follow-up and final outcomes (absence of infection) were compared between groups. Results: Forty eight patients were included, 28 in the clotrimazole group and 20 in the tolnaftate group. Spring was the weather most commonly associated with otomycosis, while otic manipulation was the risk factor more common in both groups. Predominant symptoms were itching and otic fullness. Aspergillus niger organism was isolated most frequently. Treatment with clotrimazole resulted in 75% resolution vs 45% resolution with treatment with tolnaftate at one week of treatment (p = 0.007). The Tolnaftate treatment group demonstrated higher recurrence rates and treatment failures, 20% and 15% respectively. Conclusions: Clotrimazole cream treatment is more effective than tolnaftate for uncomplicated otomycosis. More studies are needed to corroborate our results.
Resumo Introdução: Otomicose, uma infecção fúngica do canal auditivo externo, é prevalente em climas quentes e úmidos. No entanto, a literatura não apresenta evidências suficientes sobre os diferentes tratamentos antifúngicos tópicos. O tolnaftato é um antifúngico tópico descrito como eficaz no tratamento da otomicose; entretanto, sua eficácia não está suficientemente comprovada. Objetivo: Comparar a eficácia do uso de clotrimazol e tolnaftato no tratamento da otomicose. Material e método: Ensaio clínico controlado e randomizado; incluiu pacientes diagnosticados com otite externa fúngica tratados com antifúngicos tópicos, randomizados em dois grupos de tratamento: 1) clotrimazole (creme); 2) solução de tolnaftato. Eles foram avaliados microscopicamente uma e duas semanas após o início do tratamento para avaliar a resolução da doença. Recorrência e intercorrências foram registradas; além disso, as variáveis demográficas e clínicas foram coletadas e analisadas. Os dados do acompanhamento e desfechos finais (ausência de infecção) foram comparados entre os grupos. Resultados: O estudo incluiu 48 pacientes, 28 dos quais foram alocados ao grupo clotrimazole e 20 ao grupo tolnaftato. A primavera foi a estação mais comum; a manipulação foi o fator de risco mais comum em ambos os grupos. Os sintomas mais comuns foram coceira e plenitude auricular. Aspergillus niger foi o micro-organismo mais comumente isolado. Após uma semana, o tratamento com clotrimazol apresentou uma taxa de resolução de 75% vs. 45% com o tratamento com tolnaftato (p = 0,007). O tratamento com tolnaftato apresentou maiores taxas de recidiva e falhas: 20% e 15%, respectivamente. Conclusões: Em casos de otomicose não complicada, o uso de clotrimazol (creme) é mais eficaz do que o de tolnaftato. Mais estudos são necessários para corroborar os presentes resultados.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Tolnaftato/administração & dosagem , Clotrimazol/administração & dosagem , Otomicose/tratamento farmacológico , Antifúngicos/administração & dosagem , Resultado do Tratamento , Otomicose/microbiologiaRESUMO
Congenital candidiasis infection often presents as a skin rash with variable involvement of nails and mucous membranes. Isolated nail involvement is rare, may present late, and can often be managed with topical antifungal medication. We report a case of congenital candidiasis limited to the fingernails that resolved completely within 3 months with topical treatment.
Assuntos
Candidíase Cutânea/congênito , Dermatoses da Mão/microbiologia , Unhas Malformadas/congênito , Onicomicose/microbiologia , Administração Tópica , Antifúngicos/administração & dosagem , Candidíase Cutânea/tratamento farmacológico , Candidíase Cutânea/microbiologia , Clotrimazol/administração & dosagem , Feminino , Dermatoses da Mão/congênito , Dermatoses da Mão/tratamento farmacológico , Humanos , Recém-Nascido , Doenças do Recém-Nascido/tratamento farmacológico , Unhas Malformadas/tratamento farmacológico , Onicomicose/congênito , Onicomicose/tratamento farmacológicoRESUMO
INTRODUCTION: Otomycosis, an infection of the ear canal by fungi, is prevalent in hot and humid weather. Nevertheless, there is not sufficient evidence for the effectiveness of different topical antifungal treatments. Tolnaftate, is a topical antifungal agent described to be effective in the treatment of otomycosis. Currently there are not sufficient studies that prove its efficacy. OBJECTIVES: To compare the efficacy of clotrimazole and tolnaftate administration in the treatment of otomycosis. MATERIAL AND METHODS: A controlled, randomized and open clinical trial included patients diagnosed with fungal external otitis who were treated with topical antifungals, randomized into two treatment groups: (1) clotrimazole cream; (2) tolnaftate solution. They were microscopically evaluated at one and two weeks of treatment to determine resolution of disease. Recurrence and complications were recorded. Demographic and clinical variables were collected and analyzed. Follow-up and final outcomes (absence of infection) were compared between groups. RESULTS: Forty eight patients were included, 28 in the clotrimazole group and 20 in the tolnaftate group. Spring was the weather most commonly associated with otomycosis, while otic manipulation was the risk factor more common in both groups. Predominant symptoms were itching and otic fullness. Aspergillus niger organism was isolated most frequently. Treatment with clotrimazole resulted in 75% resolution vs 45% resolution with treatment with tolnaftate at one week of treatment (p=0.007). The Tolnaftate treatment group demonstrated higher recurrence rates and treatment failures, 20% and 15% respectively. CONCLUSIONS: Clotrimazole cream treatment is more effective than tolnaftate for uncomplicated otomycosis. More studies are needed to corroborate our results.
Assuntos
Antifúngicos/administração & dosagem , Clotrimazol/administração & dosagem , Otomicose/tratamento farmacológico , Tolnaftato/administração & dosagem , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Otomicose/microbiologia , Resultado do Tratamento , Adulto JovemRESUMO
Abstract Introduction Otomycosis is a common diseases that can be associated with many complications including involvement of the inner ear and mortality in rare cases. Management of otomycosis can be challenging, and requires a close follow-up. Treatment options for otomycosis include local debridement, local and systemic antifungal agents and utilization of topical antiseptics. Objective This study was designed to compare the recovery rate of otomycosis using two therapeutic methods; topical betadine (Povidone-iodine) and clotrimazole. Methods In this single-blind clinical trial, 204 patients with otomycosis were selected using a non-probability convenient sampling method and were randomly assigned to two treatment groups of topical betadine and clotrimazole (102 patients in each group). Response to treatment was assessed at 4, 10 and 20 days after treatment. Data were analyzed using the independent t-test, Chi-Square and Fisher exact test in SPSS v.18 software, at a significance level of p < 0.05. Results The results showed that out of 204 patients with otomycosis, fungi type isolated included Aspergillus in 151 cases (74%), and Candida albicans in 53 patients (26%). On the fourth day after treatment, 13 patients (13.1%) in the group treated with betadine and 10 patients (9.8%) in the group treated with clotrimazole showed a good clinical response to treatment (p = 0.75). A good response to treatment was reported for 44 (43.1%) and 47 patients (46.1%) on the tenth day after the treatment (p = 0.85); and 70 (68.6%) and 68 patients (67.6%) on the twentieth day after treatment (p = 0.46) in the groups treated with betadine and clotrimazole, respectively. The response to treatment was thus not significantly different in the two groups. Conclusion In the present study the efficacy of betadine and clotrimazole was the same for the treatment of otomycosis. The result of this study supports the use of betadine as an effective antifungal in otomycosis treatment, helping to avoid the emergence of resistant organisms.
Resumo Introdução A otomicose é uma das doenças comuns associadas a muitas complicações, como envolvimento da orelha interna e mortalidade em casos raros. O tratamento da otomicose pode ser realmente desafiador e requer um acompanhamento rigoroso. As opções de tratamento para otomicose podem incluir desbridamento local, agentes antifúngicos locais e sistêmicos e uso de antissépticos tópicos, os medicamentos tópicos recomendados para o tratamento da otomicose. Objetivo Comparar a taxa de recuperação de otomicose utilizando dois métodos terapêuticos de betadina tópica (povidona-iodo) e clotrimazol. Método Neste ensaio clínico simples cego, 204 pacientes com otomicose foram selecionados utilizando-se método de amostragem de não probabilidade conveniente e randomizados para dois grupos de tratamento, com betadina tópica e com clotrimazol (102 pacientes em cada grupo). A resposta ao tratamento foi avaliada aos 4, 10 e 20 dias após o tratamento. Os dados foram analisados utilizando o teste t independente, qui-quadrado e teste de Fisher no software SPSS v.18, com nível de significância de p < 0,05. Resultados Os resultados mostraram que dos 204 pacientes com otomicose, os tipos de fungos isolados incluíram Aspergillus em 151 casos (74%) e Candida albicans em 53 pacientes (26%). No quarto dia após o tratamento, 13 pacientes (13,1%) no grupo tratado com betadina e 10 pacientes (9,8%) no grupo tratado com clotrimazol apresentaram boa resposta ao tratamento (p = 0,75). Uma boa resposta ao tratamento foi relatada para 44 (43,1%) e 47 pacientes (46,1%) no décimo dia após o tratamento (p = 0,85); e 70 (68,6%) e 68 pacientes (67,6%) no vigésimo dia após o tratamento (p = 0,46) no grupo tratado com betadina e clotrimazol, respectivamente. Assim, a resposta ao tratamento não foi significativamente diferente nos dois grupos. Conclusão No presente estudo, a eficácia da betadina e do clotrimazol foi a mesma no tratamento da otomicose. O resultado deste estudo apoia o uso de betadina como um antifúngico eficaz no tratamento da otomicose que pode ajudar a evitar o surgimento de organismos resistentes.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Povidona-Iodo/administração & dosagem , Clotrimazol/administração & dosagem , Otomicose/tratamento farmacológico , Anti-Infecciosos Locais/administração & dosagem , Antifúngicos/administração & dosagem , Aspergillus/isolamento & purificação , Fatores de Tempo , Administração Cutânea , Candida albicans/isolamento & purificação , Método Simples-Cego , Reprodutibilidade dos Testes , Resultado do TratamentoRESUMO
This study aimed to prepare poly (d,l-lactide-co-glycolide) (PLGA) nanoparticles (NPs) with chitosan (CTS) surface modification to be used as a vaginal delivery system for antimycotic drugs. Clotrimazole was encapsulated with entrapment efficiencies of 86.1 and 68.9% into Clotrimazole-PLGA-NPs (CLT-PLGA-NPs) and PLGA-NPs with CTS-modified surface (CLT-PLGA-CTS-NPs), respectively. The later NPs exhibited a larger size and higher positive zeta potential (Z potential) in comparison to unmodified NPs. In vitro release kinetic studies indicated that Clotrimazole was released in percentages of >98% from both nanoparticulate systems after 18days. Antifungal activity and mucoadhesive properties of NPs were enhanced when CTS was added onto the surface. In summary, these results suggested that Clotrimazole loaded into PLGA-CTS-NPs has great potential for vaginal applications in treating vaginal infections generated by Candida albicans.
Assuntos
Antifúngicos/administração & dosagem , Clotrimazol/química , Preparações de Ação Retardada/administração & dosagem , Preparações de Ação Retardada/química , Nanopartículas/química , Vagina/efeitos dos fármacos , Administração Intravaginal , Animais , Antifúngicos/química , Candida albicans/efeitos dos fármacos , Células Cultivadas , Quitosana/química , Clotrimazol/administração & dosagem , Portadores de Fármacos/química , Feminino , Cinética , Tamanho da Partícula , Ácido Poliglicólico/química , SuínosRESUMO
INTRODUCTION: Otomycosis is a common diseases that can be associated with many complications including involvement of the inner ear and mortality in rare cases. Management of otomycosis can be challenging, and requires a close follow-up. Treatment options for otomycosis include local debridement, local and systemic antifungal agents and utilization of topical antiseptics. OBJECTIVE: This study was designed to compare the recovery rate of otomycosis using two therapeutic methods; topical betadine (Povidone-iodine) and clotrimazole. METHODS: In this single-blind clinical trial, 204 patients with otomycosis were selected using a non-probability convenient sampling method and were randomly assigned to two treatment groups of topical betadine and clotrimazole (102 patients in each group). Response to treatment was assessed at 4, 10 and 20 days after treatment. Data were analyzed using the independent t-test, Chi-Square and Fisher exact test in SPSS v.18 software, at a significance level of p<0.05. RESULTS: The results showed that out of 204 patients with otomycosis, fungi type isolated included Aspergillus in 151 cases (74%), and Candida albicans in 53 patients (26%). On the fourth day after treatment, 13 patients (13.1%) in the group treated with betadine and 10 patients (9.8%) in the group treated with clotrimazole showed a good clinical response to treatment (p=0.75). A good response to treatment was reported for 44 (43.1%) and 47 patients (46.1%) on the tenth day after the treatment (p=0.85); and 70 (68.6%) and 68 patients (67.6%) on the twentieth day after treatment (p=0.46) in the groups treated with betadine and clotrimazole, respectively. The response to treatment was thus not significantly different in the two groups. CONCLUSION: In the present study the efficacy of betadine and clotrimazole was the same for the treatment of otomycosis. The result of this study supports the use of betadine as an effective antifungal in otomycosis treatment, helping to avoid the emergence of resistant organisms.
Assuntos
Anti-Infecciosos Locais/administração & dosagem , Antifúngicos/administração & dosagem , Clotrimazol/administração & dosagem , Otomicose/tratamento farmacológico , Povidona-Iodo/administração & dosagem , Administração Cutânea , Adulto , Aspergillus/isolamento & purificação , Candida albicans/isolamento & purificação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Método Simples-Cego , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
The aim of present study was to enhance topical permeation of clotrimazole gel preparation by using various permeability enhancers such as coconut oil, pistachio oil and sodium lauryl sulphate (SLS). Clotrimazole gel preparations were prepared and optimized by using three factor, five level central composite design. A second-order polynomial equation was generated in order to estimate the effect of independent variables i.e. coconut oil (X1), pistachio oil (X2) and sodium lauryl sulphate (X3) at various dependent variables i.e. flux (Y1), lag time (Y2), diffusion coefficient (Y3), permeability coefficient (Y4), and input rate (Y5) of clotrimazole gel formulations. Ex vivo skin permeation study was performed through rat skin by using modified Franz diffusion cell system. Optimized formulation F8 exhibited highest flux 2.17 µg/cm2/min, permeability coefficient 0.0019 cm/min and input rate 1.543 µg/cm2/min, along with moderate lag time 77.27 min and diffusion coefficient 0.063 cm2/min, which is further supported by anti-fungal activity that exhibited more prominent zone of inhibition against Candida albicans, Aspergillus niger and Mucor. Thus, it can be concluded that permeation of clotrimazole gel was enhanced by various combination of coconut oil, pistachio oil and sodium lauryl sulphate but optimized formulation F8 containing 0.4 ml pistachio oil, 0.8 ml coconut oil and 0.04 g of SLS exhibited more pronounced and promising effect through rat skin.
Assuntos
Acrilatos , Clotrimazol/síntese química , Administração Tópica , Animais , Clotrimazol/administração & dosagem , Clotrimazol/farmacocinética , Óleo de Coco/farmacologia , Composição de Medicamentos/métodos , Géis , Técnicas In Vitro , Pistacia/química , Óleos de Plantas/farmacologia , Ratos , Absorção Cutânea , Dodecilsulfato de Sódio/farmacologiaRESUMO
The objective of this work was to propose coconut oil-core nanocapsules prepared from Eudragit(®) RS100, a cationic polymer, and to evaluate their potential for vaginal delivery of clotrimazole in candidiasis. Nanocapsule suspensions loaded with clotrimazole at 1.0 and 3.0mg/mL were prepared by interfacial deposition of Eudragit(®) RS100. The physicochemical characterization showed average diameter lower than 200 nm, low polydispersity index, positive zeta potential (+10.94 to +14.57 mV), acid pH values (5.4-5.7) and encapsulation efficiencies close to 100%. After 60 days of storage at room temperature and protected from light, the nanocapsules were reasonably stable. Photodegradation studies showed that nanoencapsulation improved clotrimazole stability against UV radiation. The in vitro drug release at pH 4.5 was characterized by a prolonged release with no burst effect. The nanocapsules were more active than free clotrimazole against Candida albicans and Candida glabrata strains susceptible and resistant to fluconazole. Hence, clotrimazole-loaded coconut oil-core nanocapsules represent promising alternatives to the treatment of vulvovaginal candidiasis.
Assuntos
Antifúngicos/administração & dosagem , Antifúngicos/farmacologia , Clotrimazol/administração & dosagem , Clotrimazol/farmacologia , Sistemas de Liberação de Medicamentos , Nanocápsulas/química , Óleos de Plantas/química , Administração Intravaginal , Antifúngicos/química , Candida albicans/efeitos dos fármacos , Candida glabrata/efeitos dos fármacos , Candidíase Vulvovaginal/tratamento farmacológico , Candidíase Vulvovaginal/microbiologia , Cátions/química , Clotrimazol/química , Óleo de Coco , Feminino , Humanos , Testes de Sensibilidade Microbiana , Tamanho da Partícula , Polímeros/química , Propriedades de SuperfícieRESUMO
Presenta estudio descriptivo, prospectivo de corte transversal, realizado en el Departamento de Obstetricia ubicado en el segundo piso del Hospital Escuela Dr. Oscar Danilo Rosales. La población del estudio fueron 1104 las mujeres gestantes a las que se atiende su parto o cesárea. La mayor parte de las pacientes cursaban su primer embarazo 32 porciento siendo un porcentaje elevado (13). En relación a los antecedentes personales el 2.7 porciento corresponde a la hipertensión, la cual es una de las principales complicaciones que se encuentran con mayor frecuencia durante el embarazo. Loscmedicamentos consumidos durante el embarazo principalmente fueron amoxicilina, clotrimazol y cefalexina. No se obervaron malformaciones fetales en los recién nacidos. Finalmente durante el estudio se captaron dos muertes perinatales correspondientes a mujeres menores de 25 años una en el 2006 y otra 2007...
Assuntos
Amoxicilina/administração & dosagem , Cesárea , Clotrimazol/administração & dosagem , Período Pós-Parto , Complicações na Gravidez , Gestantes , Fatores de Risco , Cefalexina/administração & dosagemRESUMO
A prospective study to identify clinical and mycological aspects of oral candidiasis including a therapeutic trial for 4 drugs-2 topical (chlotrimazole and nistatine) and 2 systemic (itraconale and ketoconazole) was performed on 97 HIV adult patients from March 2003 to June 2004. Average age was 34.97 years, being males and heterosexual behaviour predominant. The pseudomembranous clinical form of presentation prevailed in 93.8% of cases, with accompanying symptoms like pain, burning sensation and difficult swallowing in addition to extensive lesions. Candida albicans was the most frequently isolated species both in swabs taken at the beginning (92%) and at the end of the treatment schedules applied to patients who did not succeed in mycological cure (89.4%). Treatment schemes had positive results from the clinical viewpoint in 91.8% of cases with improvement or total remission of symptoms and signs, and in 51.6% of mycological curing. There were no statistically significant differences of clinical and mycological responses between topical and systemic treatments. The above-mentioned allowed recommending a more extensive use of local treatment in the studied population because of their benefits for the patients.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Antifúngicos/uso terapêutico , Candidíase Bucal/epidemiologia , Clotrimazol/uso terapêutico , Soropositividade para HIV/epidemiologia , Itraconazol/uso terapêutico , Cetoconazol/uso terapêutico , Nistatina/uso terapêutico , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Síndrome da Imunodeficiência Adquirida/epidemiologia , Administração Oral , Administração Tópica , Adulto , Candida/classificação , Candida/isolamento & purificação , Candidíase Bucal/tratamento farmacológico , Candidíase Bucal/microbiologia , Clotrimazol/administração & dosagem , Feminino , Humanos , Itraconazol/administração & dosagem , Cetoconazol/administração & dosagem , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Nistatina/administração & dosagem , Estudos Prospectivos , Fatores de Risco , Comportamento Sexual , Método Simples-Cego , Especificidade da Espécie , Resultado do Tratamento , Adulto JovemRESUMO
Ketoconazole (KTZ) has been used as a second-line agent in hormone-refractory cancer therapy. Since transition metal complexes including those of Ru(III), show important anticancer activity with limited toxicity, we investigated the potential antitumor efficacy of Ru(II) complexed to KTZ or clotrimazole (CTZ) compared to Ru(II) alone or uncomplexed azoles. RuCl2(KTZ)2 exerted greater apoptosis- associated caspase-3 activation than RuCl2(CTZ)2, KTZ, CTZ or RuCl2(MeCN)4 against several human tumor cell monolayers. PARP cleavage and a decrease in S+G2 cells were evident after RuCl2(KTZ)2 treatment in genetically matched C8161 melanoma monolayers with unequal p53 functional status. Release of mitochondrial cytochrome c and Mn-SOD suggest mitochondria as a target of RuCl2(KTZ)2. Treatment of WM164 melanoma monolayers with 25 microM of cisplatin or RuCl2(KTZ)2 showed that the latter is more effective than cisplatin at inducing PARP fragmentation and proapoptotic Bak expression. Such results suggest that these Ru(II) and Pt(II) metal complexes are unequally effective and act through alternative signaling pathways. In studies with multicellular spheroids, which frequently are more resistant to cytotoxic anticancer drugs than monolayers, those from wt p53 C8161 melanoma underwent PARP fragmentation in response to RuCl2(KTZ)2. In contrast, spheroids of mut p53 A431 carcinoma overexpressing EGF receptor were resistant to either RuCl2(KTZ)2 or anti-EGF receptor C225 MAb. However, joint treatment with both agents restored growth arrest and apoptosis in these spheroids. In contrast to the antitumor action of cisplatin, which is known to be hampered by p53 dysfunction, we show that RuCl2(KTZ)2 is active irrespective of p53 functional status against several adherent tumor cells and synergizes with anti-EGF receptor C225 MAb to kill tumor spheroids resistant to either agent.
Assuntos
Anticorpos Monoclonais/farmacologia , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Apoptose/efeitos dos fármacos , Receptores ErbB/imunologia , Neoplasias/patologia , Caspase 3 , Caspases/metabolismo , Cisplatino/administração & dosagem , Clotrimazol/administração & dosagem , Terapia Combinada , Citocromos c/metabolismo , Sinergismo Farmacológico , Ativação Enzimática/efeitos dos fármacos , Humanos , Cetoconazol/administração & dosagem , Proteínas de Membrana/metabolismo , Mitocôndrias/efeitos dos fármacos , Neoplasias/metabolismo , Poli(ADP-Ribose) Polimerases , Compostos de Rutênio/administração & dosagem , Compostos de Rutênio/uso terapêutico , Esferoides Celulares/patologia , Superóxido Dismutase/metabolismo , Células Tumorais Cultivadas , Proteína Supressora de Tumor p53/metabolismo , Proteína Killer-Antagonista Homóloga a bcl-2RESUMO
A infecçäo recorrente da mucosa vaginal pela Candida albicans foi abordada realçando-se os mecanismos de interaçäo entre o fungo e o epitélio vaginal, com ênfase para os aspéctos imunológicos que controlam a proliferaçäo fúngica. Destaca-se o papel da imunidade celular mediada neste processo de eqüilibrio entre agente e hospedeiro, reforçando a importância via Th1, de resposta imune, onde há uma liberaçäo de citocinas como interferon-gama, interleucina-1 e 12. Por outro lado, a via Th2 que libera citocinas estimulantes da produçäo de anticorpos (interleucinas-4, 5 and 10) tera valor limitado na defesa da mucosa contra este agente. Comenta-se também o aspécto fisiopatogênico envolvendo resposta imune ligada aos processos alérgicos individuais e em decorrência de interaçäo como parceiro sexual. O diagnóstico principal "arma" para o tratamento adequado, é enfocado com ênfase na prática, reforçando-se o uso de bacterioscopias simples, sem esquecer que técnicas sofisticadas, como PCR, podem vir a ser útil para determinados casos. O tratamento da fase aguda e de manutençäo foi sugerido na tentativa de diminuir as recorrências, alertando-se principalmente para necessidade de tomar atitudes que visem näo somente o combate ao fungo, mas que também e fudamentalmente, priorize a identificaçäo e eliminaçäo de possíveis alérgenos
Assuntos
Candidíase Vulvovaginal/diagnóstico , Candidíase Vulvovaginal/imunologia , Candidíase Vulvovaginal/tratamento farmacológico , Clotrimazol/administração & dosagem , Fluconazol/administração & dosagem , Itraconazol/administração & dosagem , Cetoconazol/administração & dosagem , Miconazol/administração & dosagemRESUMO
Foi realizado estudo comparativo entre o uso de oxiconazol creme a 1%, em dose única diária, e clotrimazol creme a 1% em duas aplicaçöes diárias em dois grupos de 15 pacientes com tinea corporis e/ou cruris. Os pacientes foram avaliados clínica e micologicamente no pré-tratamento, na 1ª, 2ª e 4ª semanas após o início do tratamento. O trichophyton rubrum foi isolado em 66% de casos. Ao término do estudo pudemos verificar que näo só a resposta clínica e micológica bem como o resultado final de ambos os grupos näo diferiu estatisticamente. Houve cura em 100% dos pacientes. Os autores concluem que o oxiconazol creme apresenta as seguintes vantagens sobre o clotrimazol: um gasto duas vezes menor de medicamento e de tempo por parte do paciente na obtençäo de resultados clínicos e micológicoss semelhantes. O oxiconazol representa um avanço na terapia antimicótica por ser eficaz e seguro, apresentando como vantagem adional a comodidade de poder ser utilizado numa única aplicaçäo diária
Assuntos
Adulto , Humanos , Masculino , Feminino , Antifúngicos/uso terapêutico , Clotrimazol/uso terapêutico , Tinha/tratamento farmacológico , Antifúngicos/uso terapêutico , Clotrimazol/administração & dosagem , PomadasRESUMO
The combination creams, betamethasone dipropionate/clotrimazole/gentamicin sulphate and flumethasone pivalate/clioquinol, were compared in patients with corticosteroid responsive dermatoses and/or cutaneous fungal and/or bacterial infections. Medication was applied to affected areas twice daily for 28 days. Of 67 patients enrolled, 31 treated with betamethasone/clotrimazole/gentamicin and 33 given flumethasone pivalate/clioquinol were evaluated for efficacy and safety each week during therapy and once 14 days post-therapy. Disease signs and symptoms were less severe in the group given betamethasone/clotrimazole/gentamicin than in the comparative group at days 7 (P = 0.04), 21 (P = 0.02), 28 (P = 0.09), and 42 (P = 0.09) and at patients' last valid visit (P = 0.06). By the last valid visit, signs/symptoms had improved by 82% for patients treated with betamethasone/clotrimazole/gentamicin versus 68% for those treated with flumethasone pivalate/clioquinol. Patients given betamethasone/clotrimazole/gentamicin had statistically significantly better therapeutic responses than those given flumethasone pivalate/clioquinol at day 7 and, by the last valid visit, 19/31 (61%) patients given betamethasone/clotrimazole/gentamicin compared to 15/33 (45%) given flumethasone pivalate/clioquinol had a complete cure or an excellent therapeutic response. Median time of onset of relief of erythema and pruritus was approximately 2 days, regardless of treatment. No adverse reactions were reported.
Assuntos
Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Antifúngicos/uso terapêutico , Dermatopatias/tratamento farmacológico , Administração Tópica , Adolescente , Adulto , Idoso , Betametasona/administração & dosagem , Betametasona/análogos & derivados , Betametasona/uso terapêutico , Ensaios Clínicos como Assunto , Clioquinol/administração & dosagem , Clioquinol/uso terapêutico , Clotrimazol/administração & dosagem , Clotrimazol/uso terapêutico , Dermatomicoses/tratamento farmacológico , Quimioterapia Combinada , Feminino , Flumetasona/administração & dosagem , Flumetasona/análogos & derivados , Flumetasona/uso terapêutico , Gentamicinas/administração & dosagem , Gentamicinas/uso terapêutico , Glucocorticoides , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição Aleatória , Dermatopatias Infecciosas/tratamento farmacológico , Fatores de TempoAssuntos
Candidíase Vulvovaginal/tratamento farmacológico , Clotrimazol/uso terapêutico , Imidazóis/uso terapêutico , Adulto , Clotrimazol/administração & dosagem , Avaliação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Cremes, Espumas e Géis VaginaisRESUMO
60 cases of superficial micosis were studied (tinea corporis, cruris, pedis and versicolor). The results canesten (clotrimazol) were evaluated. The lesions were cured with a period no longer than 12 weeks.