The in vitro antifungal activity of ketoconazole, zinc pyrithione, and selenium sulfide against Pityrosporum and their efficacy as a shampoo in the treatment of experimental pityrosporosis in guinea pigs

Cutsem, J. Van; Gerven, F. Van; Fransen, J.; Schrooten, P.; Janßen, Paul

doi:10.1016/0190-9622(90)70140-d

Cited by 97 publications

(68 citation statements)

References 16 publications

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“…Hammer et al (14) studied the in vitro activity of KTC, econazole, and miconazole against 54 Malassezia isolates and observed that the most potent inhibitor in vitro was KTC (0.03 to 0.25 g/ml). These findings are similar to those of previous reports (9,16,28,29).…”

supporting

confidence: 83%

In Vitro Susceptibilities ofMalasseziaSpecies to a New Triazole, Albaconazole (UR-9825), and Other Antifungal Compounds

Garau

Pereiro

Palacio

2003

Antimicrob Agents Chemother

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The in vitro activity of the new triazole albaconazole (UR-9825) in comparison with those of flucytosine, fluconazole, ketoconazole, itraconazole, and voriconazole against 70 strains of Malassezia spp. was determined by a microdilution method using a colorimetric indicator for metabolic activity. Albaconazole showed an in vitro profile similar to those of the different antifungals tested (MIC < 0.06 g/ml for all the strains).Yeasts of the genus Malassezia are part of the normal mycota of the skin of humans and other warm-blooded animals, particularly in areas rich in sebaceous glands (19). Malassezia species may also be etiological agents of skin disorders and, uncommonly, systemic infections (3, 6, 16, 24, 30).In 1997, the National Committee for Clinical Laboratory Standards approved a broth micro-and macrodilution method for susceptibility testing of yeasts with RPMI 1640 medium (NCCLS-M27A) (21). However, this document is not applicable to Malassezia species other than Malassezia pachydermatis, because these organisms do not grow without lipidic substances in the medium. Only a few systems for in vitro susceptibility testing of Malassezia species have been described. In addition to present measurements in solid media, several microdilution methods have been used, but the different liquid media used, such as modified Dixon (19,27) and LeemingNotman (15), are turbid; consequently, the visual and turbidimetric results are difficult to interpret. A liquid medium method has been observed to overcome the difficulties in growth reading if one uses a colorimetric indicator for metabolic activity (Alamar blue) (25). Recently, Nakamura et al. (20) described a new microdilution method based on the urease activity of Malassezia spp.Albaconazole (ABC) is a new systemic triazole under development by J. Uriach & Cia S.A. (Barcelona, Spain) with both potent and broad-spectrum antifungal activity, good pharmacokinetics, and excellent bioavailability. It has demonstrated good in vitro activities against pathogenic yeasts (23), dermatophytes (10), and some filamentous fungi (4), including Scedosporium prolificans (5). It has also been shown to be active in the treatment of systemic aspergillosis and candidiasis in experimental animal models (2).The aim of this study was to compare the in vitro activity of ABC with those of five antifungal drugs, namely, flucytosine (5FC), fluconazole (FLC), ketoconazole (KTC), itraconazole (ITC), and voriconazole (VRC), against 70 isolates of Malassezia, namely, M. furfur (n ϭ 24), M. pachydermatis (n ϭ 10), M. sympodialis (n ϭ 21), and M. slooffiae (n ϭ 15). M. furfur was obtained from human skin, that of neonates with long stays in intensive care units. M. pachydermatis and M. slooffiae were obtained from healthy and diseased ears of dogs and pigs, respectively. M. sympodialis was isolated from normal human skin. Susceptibility testing of the drugs was initially performed with M. restricta (n ϭ 1), M. obtusa (n ϭ 1), and M. globosa (n ϭ 24). However, we were unable to obtain MICs due to the ...

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confidence: 83%

In Vitro Susceptibilities ofMalasseziaSpecies to a New Triazole, Albaconazole (UR-9825), and Other Antifungal Compounds

Garau

Pereiro

Palacio

2003

Antimicrob Agents Chemother

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“…A relatively small difference between inhibitory and fungicidal values was seen for ketoconazole, but not for econazole or miconazole. Van Cutsem et al (19) showed a similar effect for ketoconazole against 10 strains of Pityrosporum ovale. In our study, M. furfur was the least susceptible species.…”

mentioning

confidence: 69%

In Vitro Activities of Ketoconazole, Econazole, Miconazole, and Melaleuca alternifolia (Tea Tree) Oil against Malassezia Species

Hammer

Carson

Riley

2000

Antimicrob Agents Chemother

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The in vitro activities of ketoconazole, econazole, miconazole, and tea tree oil against 54 Malassezia isolates were determined by agar and broth dilution methods. Ketoconazole was more active than both econazole and miconazole, which showed very similar activities. M. furfur was the least susceptible species. M. sympodialis, M. slooffiae, M. globosa, and M. obtusa showed similar susceptibilities to the four agents.Lipid-dependent Malassezia yeasts are commonly found on human skin, in particular, on the upper body, where sebum excretion is highest (10, 13). Although usually saprophytic, Malassezia spp. are also considered to be etiological agents in superficial skin diseases, such as pityriasis versicolor, seborrhoeic dermatitis, and Malassezia folliculitis, and infrequently cause systemic disease associated with lipid-rich hyperalimentation fluids (13).Recently, several new Malassezia species have been described, resulting in seven species now being included in the genus (3, 4). Despite these major taxonomic revisions, little work has subsequently been published about the in vitro susceptibilities of these species to various antifungal agents. Therefore, the aim of this study was to determine the comparative activities of ketoconazole, econazole, miconazole, and the topical agent tea tree oil against Malassezia species.The following reference strains were obtained from the Centraalbureau voor Schimmelcultures (CBS), Baarn, The Netherlands: M. furfur CBS 1878, M. globosa CBS 7966, M. obtusa CBS 7876, M. slooffiae CBS 7956, and M. sympodialis CBS 7222. The following isolates were obtained in our laboratory as described previously (6); M. furfur (n ϭ 10), M. globosa (n ϭ 4), M. obtusa (n ϭ 1), M. slooffiae (n ϭ 2), and M. sympodialis (n ϭ 30). These were identified according to previously published methods (3,5,11,14). In addition, one isolate of M. sympodialis was kindly provided by Chris Heath at the Department of Microbiology and Infectious Diseases, Royal Perth Hospital, and one isolate of M. furfur was kindly provided by The Western Australian Centre for Pathology and Medical Research. All organisms were maintained on Dixon's agar (18), and all incubations, including susceptibility tests, were at 32°C.Tea tree oil (batch 971) was kindly supplied by Australian Plantations Pty. Ltd., Wyrallah, New South Wales, Australia, and complied with the International Standard ISO 4730 (7, 8). Stock solutions of econazole (Sigma Chemical Co., St. Louis, Mo.), miconazole (Sigma), and ketoconazole (Janssen Biotech, Olen, Belgium) powders were prepared in dimethyl sulfoxide and stored at Ϫ20°C.For broth and agar dilution assays, inocula were prepared by growing organisms on Dixon's agar for 72 h. Colonies were suspended in saline, and suspensions were adjusted to approximately 5 ϫ 10 6 CFU/ml, as determined by viable counts. For the agar dilution assay, a series of twofold dilutions of each agent were prepared in medium A agar (10). Final concentration ranges were as follows: tea tree oil, 0.008 to 1.0% (vol/vol); ketoconazol...

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“…In vitro studies have shown that agents such as KET, ZPT, selenium sulfide and piroctone olamine have good activity against human strains of M. furfur [8][9][10][11]. Animal models have shown that the activity of KET 2% shampoo in pityrosporosis was greater than that of ZPT 1 and 2% or of selenium sulfide 2.5% shampoos [9]. Anti-inflammatory and so-called keratolytic properties are believed to enhance the efficacy of antidandruff compounds.…”

Section: Discussionmentioning

confidence: 99%

“…activity of ketoconazole (KET) and zinc pyrithione (ZPT) [8][9][10][11]. KET inhibits the biosynthesis of ergosterol, the main sterol in the fungal cell membrane [12].…”

Section: Introductionmentioning

confidence: 99%

A Multicenter Randomized Trial of Ketoconazole 2% and Zinc Pyrithione 1% Shampoos in Severe Dandruff and Seborrheic Dermatitis

Piérard-Franchimont

Goffin

Decroix³

et al. 2002

Skin Pharmacol Physiol

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Ketoconazole (KET) and zinc pyrithione (ZPT) are compounds active against the Malassezia spp. yeasts, which are believed to play a major role in dandruff and seborrheic dermatitis. We compared the efficacy and safety of KET 2% and ZPT 1% in shampoo formulations for the alleviation of severe dandruff and seborrheic dermatitis. This open randomized, parallel-group trial began with a 2-week run-in phase during which subjects applied a neutral nonantidandruff shampoo. It was followed by a 4-week randomized treatment phase and a subsequent 4-week follow-up phase without treatment. Shampooing during the treatment period was carried out twice weekly for the KET group and at least twice weekly for the ZPT group in accordance with the label instructions. A total of 343 subjects were recruited to enter the trial. Of the 331 eligible volunteers, 171 were randomized to KET 2% and 160 to ZPT 1%. Clinical assessments were performed. Beneficial effects were evidenced for both medicated shampoos, but the effect was significantly better for KET 2%, which achieved a 73% improvement in the total dandruff severity score compared with 67% for ZPT 1% at week 4 (p < 0.02). The recurrence rate of the disease was also significantly lower following KET 2% treatment than following ZPT 1% treatment. As a consequence, the overall clearing of the skin condition at the end of treatment and follow-up phase was in favor of the KET 2% formulation (p = 0.004). Side effects were minimal. It is concluded that after a 4-week treatment, KET 2% shampoo was significantly superior to ZPT 1% shampoo in the treatment of subjects with severe dandruff or seborrheic dermatitis of the scalp. It is our assumption that this difference is noticeable for the patient and as a consequence relevant. Both formulations were well tolerated.

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The in vitro antifungal activity of ketoconazole, zinc pyrithione, and selenium sulfide against Pityrosporum and their efficacy as a shampoo in the treatment of experimental pityrosporosis in guinea pigs

Cited by 97 publications

References 16 publications

In Vitro Susceptibilities ofMalasseziaSpecies to a New Triazole, Albaconazole (UR-9825), and Other Antifungal Compounds

In Vitro Susceptibilities ofMalasseziaSpecies to a New Triazole, Albaconazole (UR-9825), and Other Antifungal Compounds

In Vitro Activities of Ketoconazole, Econazole, Miconazole, and Melaleuca alternifolia (Tea Tree) Oil against Malassezia Species

A Multicenter Randomized Trial of Ketoconazole 2% and Zinc Pyrithione 1% Shampoos in Severe Dandruff and Seborrheic Dermatitis

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