Emerging Trends in the Use of Topical Antifungal-Corticosteroid Combinations

Abstract

A broad range of topical antifungal formulations containing miconazole or terbinafine as actives are commonly used as efficacious choices for combating fungal skin infections. Their many benefits, owing to their specific mechanism of action, include their ability to target the site of infection, enhance treatment efficacy and reduce the risk of systemic side effects. Their proven efficacy, and positioning in the treatment of fungal skin infections, is enhanced by high patient compliance, especially when appropriate vehicles such as creams, ointments and gels are used. However, inflammation as a result of fungal infection can often impede treatment, especially when combined with pruritus (itch), an unpleasant sensation that elicits an urge to scratch. The scratching that occurs in response to pruritus frequently accelerates skin damage, ultimately aggravating and spreading the fungal infection. To help overcome this issue, a topical antifungal-corticosteroid combination consisting of miconazole or terbinafine and corticosteroids of varying potencies should be used. Due to their inherent benefits, these topical antifungal-corticosteroid combinations can concomitantly and competently attenuate inflammation, relieve pruritus and treat fungal infection.

Selenization of Small Molecule Drugs: A New Player on the Board

“…At present, the main opportunistic pathogen species involved in most cases of IFIs are Aspergillus spp., Cryptococcus spp., and Candida spp. It should be emphasized that numerous studies have unveiled the crucial role of ergosterol biosynthesis in the survival of the strains involved in these infections, as it is a major component of the fungal membranes. − In this regard, several therapeutic strategies have been proposed such as targeting CYP51 (lanosterol 14α-demethylase, Erg11), which is part of the cytochrome P450 monooxygenase superfamily and plays a key role in the synthesis of ergosterol. − It is well-established that various azole drugs, such as fluconazole and miconazole, display a fungistatic activity by inhibiting this enzyme . Nevertheless, the efficacy of the clinically available drugs is mainly compromised by interactions between drugs, host toxicity, narrow antifungal spectrum, and pharmacokinetic variability.…”

Trichophyton indotineae, an Emerging Drug-Resistant Dermatophyte: A Review of the Treatment Options

“…In clinical practice, fixed-drug combinations (FDCs) containing corticosteroids alongside antifungal agents are also widely used. While corticosteroids offer rapid symptom relief by mitigating local inflammatory reactions, their inclusion may promote improper self-medication [ 18 , 19 , 20 ]. Incorrect and uncontrolled use of FDCs and topical antifungals may contribute to the emergence and spread of multidrug-resistant dermatophytosis [ 21 , 22 ].…”

Rising burden of superficial fungal infections in India and the role of Clotrimazole for optimal management

“…Azoles are the 1 st line treatment option for many fungal infections, including dermatomycoses and candidiasis and systemic mycoses. 33 They are the most widely used class of clinical antimycotics that is sub classified into imidazoles (clotrimazole, miconazole, econazole and ketoconazole) and triazoles (fluconazole and itraconazole) depending on their chemical structure. 34 Azoles are the drug of choice because of the anti-inflammatory, antibacterial and broad spectrum activity.…”