Topical Azoles
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
A 80–90% clinical and mycologic cure rate was achieved with intravaginal administration of 600 mg isoconazole nitrate in women with vaginal candidiasis, and an open comparative study of isoconazole and oral ketoconazole found no difference in efficacy between the two treatments (Fromtling, 1988). In addition to the activity of isoconazole as monotherapy in the treatment of dermatophytic skin infections, the combination of isoconazole with topical corticosteroids has proven useful in the treatment of inflammatory dermatomycoses (Czaika, 2008; Havlickova and Friedrich, 2008; Veraldi, 2013).
Male methods
Suzanne Everett in Handbook of Contraception and Sexual Health, 2020
Various preparations affect the efficacy of the condom. Oil-based preparations should not be used with latex containing condoms as they damage the latex rubber; these include lipstick, body oils, massage oils, baby oils butter, ice cream and Vaseline. Vaginal and topical preparation should not be used with latex as they may cause damage; these include econazole, miconazole, isoconazole, fenticonazole and clotrimazole.
Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Anton C. de Groot in Monographs in Contact Allergy, 2021
Isoconazole is an azole antifungal drug that is used in the treatment of dermatomycoses and vaginal Candida infections. In pharmaceutical products, both isoconazole and its salt isoconazole nitrate (CAS number 24168-96-5, EC number 246-051-4, molecular formula 246-051-4) may be employed (1).
The association of isoconazole–diflucortolone in the treatment of pediatric tinea corporis
Published in Journal of Dermatological Treatment, 2018
Stefano Veraldi, Rossana Schianchi, Paolo Pontini, Alberto Gorani
As previously mentioned, we believe that staphylococcal superinfections of tinea corporis in atopic children are due to scratching. A once daily application of isoconazole and diflucortolone cream for 5–7 days, followed by the application of a specific antimycotic, reduces the itching, the scratching, and bacterial superinfections. Furthermore, it was demonstrated that isoconazole is effective in vitro on S. aureus: the minimal inhibitory concentration was 6.3 μg ml−1 (2–6). However, isoconazole has no activity on Gram-negative bacteria (4,5). The antibacterial action of isoconazole involves an increase in reactive oxygen substances (ROS). The increased ROS levels within bacteria results in oxidative stress that causes apoptosis and cell death (5). In 2012, two of us (SV and RS) published the results of a multicenter, sponsor-free study that evaluated the clinical and mycological efficacy and tolerability of the combination isoconazole–diflucortolone cream (twice daily for one week, followed by isoconazole cream alone, twice daily for two weeks) compared with a monotherapy with isoconazole cream (twice daily for three weeks) in adult patients with tinea inguinalis. The combination isoconazole–diflucortolone was superior to isoconazole alone regarding erythema and pruritus: both of them resolved in a larger percentage of patients and more quickly. No side effects were reported or observed in both groups. Mycological cure rates were similar in both groups: 83.9% in the monotherapy group and 85.2% in the combination group (7). The combination isoconazole–diflucortolone showed to be effective in some anedoctical cases of tinea corporis (8), tinea cruris (9–11), tinea pedis (12–14), tinea incognito (15), and intertrigo (16–19) and balanitis (18) by Candida albicans. Our study in atopic children with tinea corporis superinfected by S. aureus confirms that a topical therapy with the association isoconazole–diflucortolone can be useful for several reasons: (a) isoconazole eradicates causative microorganisms, (b) diflucortolone induces a rapid improvement of pruritus, (c) another benefit is the increased bioavailability of isoconazole in the skin, when it is applied together with diflucortolone: due to the local vasoconstrictive action of diflucortolone, the dispersal of isoconazole via the circulation is delayed (20,21). After 24 h of exposure to the combination isoconazole–diflucortolone, epidermal, and dermal isoconazole concentrations reach 120 and 13 μg ml−1, respectively, compared to 40 and 4 μg ml−1, respectively, for isoconazole alone (21): the duration of antimycotic activity is therefore prolonged, (d) the incorporation of a corticosteroid reduces the risks of irritant and allergic contact dermatitis that can be caused by topical antimycotics, (e) finally, the incorporation of a topical corticosteroid reduces scratching and the incidence of bacterial superinfections. Similar clinical results were observed in single pediatric cases of tinea corporis (22–25). The possibility that topical corticosteroids induce skin atrophy is purely theoretical, if we consider the single daily application and the duration (5–7 days).
Related Knowledge Centers
- Antifungal
- Azole
- Corticosteroid
- Clotrimazole
- Bioavailability
- Diflucortolone