Summary. The need for a topical, non‐traumatic treatment for onychomycoses of different etiologies has led to a search for increased effectiveness by associating products which have different and complementary effects, as is the case of the keratoplastic and broad‐spectrum antifungal agents. Using a 40% urea and 1% bifonazole cream, 42 nails with fungal infections (28 patients) were treated until the infected area softened and could be removed, after which 1% bifonazole cream was applied. After a 6 to 12 month follow‐up, the treatment success rate has been 93.8% for fingernails and 88.5% for toenails. The cultures became negative within 3 weeks after starting therapy with urea and bifonazole. Tolerance was good and it was not necessary to stop treatment in any patient. The topical, combined use of urea and bifonazole is a good alternative in the treatment of onychomycoses of different etiologies, provided that strict compliance by the patient is ensured, and that the application instructions are followed correctly.
Zusammenfassung. Die Notwendigkeit einer lokalen, nichtinvasiven Behandlung der Onychomykose verschiedenen Ursprungs hat zur Suche nach erhöht wirksamen Stoffkombinationen mit verschiedenen, einander ergänzenden Wirkungen geführt, wie beispielsweise keratoplastische und pilzabtötende Substanzen mit breitem Spektrum. Unter Verwendung einer Creme mit 40% Harnstoff und 1% Bifonazol wurden 42 pilzbefallene Nägel (28 Patienten) behandelt, bis eine Erweichung und Ablösung des befallenen Bereichs erreicht war; danach wurde 1% iger Bifonazol‐creme weiterbehandelt. Nach 6 bis 12 Monaten lag der Behandlungserfolg für Fingernägel bei 93.8% und 88.5% für Fußnägel. Drei Wochen nach Behandlungsbeginn mit Harnstoff und Bifonazol wurden die Kulturen negativ. Die Verträglichkeit war gut, und die Behandlung mußte bei keinem Patienten abgebrochen werden. Der kombinierte lokale Einsatz von Harnstoff und Bifonazol stellt eine gute Alternative zur Behandlung von Nagelmykosen unterschiedlicher Ätiologie dar, sofern der Patient die verschriebene Behandlung streng einhält und die Anwendungsvorschriften genau befolgt.
In vitro susceptibility to the sordarin derivative GM 237354 and amphotericin B were tested in a total of 190 Cryptococcus neoformans clinical isolates from different geographical areas of Spain and South American countries. Minimal inhibitory concentrations (MICs) were obtained using the NCCLS reference microbroth dilution method and analysed according the serotypes of Cr. neoformans. The MICs for amphotericin B were lower than 1.0 microg ml(-1) (MIC90% 0.5 microg ml(-1) , MIC50% 0.125 microg ml(-1)) but five isolates showed MICs of 2.0 microg ml(-1) to GM 237354 (MIC90% 1.0 microg ml(-1), MIC50% 0.5 microg ml(-1)). Cryptococcus neoformans var. gattii serotype B, was significantly less susceptible than A and AD serotypes (P = 0.047 and P = 0.022, respectively).
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