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search by tricolsan spore - www.infectioncontroltoday.com/articles/321bpract.html
Date: September 19, 2003 01:49 PM
Author: Marilynn
Subject: Olive Leaf extract
I have had really good experiences with Olive Leaf. I use the Roex brand (roex.com) It is pharmaceutical grade and contains 17 to 22% oleuropean (depending on the time of year it is harvested) which is the active ingredient. I have looked for others, but only found ones that were 6% oleuopean - I am sure there are others, I just haven't hunted hard enough, but since I am satisfied with Roex, its okay. We keep it on hand and if taken every four hours at the very first sign of anything, generally stops it cold within a day. If you get something and it gets started, it will not stop it but will reduce the time you are miserable. My brother has Hepatitis C and we have been using the olive leaf (it has the ability to shred the protein covering on viruses) along with MG beta glucan from NSC (nsc24.com)(this one does not reaggregate in the intestines and it modulates the immune system), also a lot of other supplements aimed at the liver. He was keeping the viral load slowed down but still raising steadily each year until he added the olive leaf and beta glucan, which seems to have been the one two punch. His viral load is now reducing steadily for the last two years.
(http://www.agora-inc.com/forums/Index.cfm?CFApp=16&Message_ID=73457)
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Date: September 10, 2003 03:28 PM
Author: Denise
Subject: Olive leaf - BUMP UP!!
Here's the thread
(http://www.agora-inc.com/forums/Index.cfm?CFApp=16&Message_ID=71142)
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Date: September 18, 2003 11:05 PM
Author: Lyn
Subject: anti-bacterial, viral, fungal
In addition to olive leaf, I have found a good natural antiviral, bacterial & fungal to be Tea Tree Oil - readily available in Australia but I believe also available overseas. Green tea is also excellent - both internally and topically for minor infections and of course apple cider vinegar. In addition to taking a little internally - I also use it to wash with as I have very sensitive skin and have a bad reaction to soap. I have not had any problems since starting to use cider vinegar instead of soap. If your skin problem is sensitivity due to dryness and not an infection, then aloe vera jelly applied topically followed by a light application of blended cold pressed oils - e.g. wheat germ, macadamia, evening primrose,& a little lavender and calendula while skin is damp should help. Since using this regime which I developed by trial and error, I have received many compliments on my skin - I am in my 50's. Also take L-cysteine which boosts the immune system and is anti-bacterial and anti-viral.
(http://www.agora-inc.com/forums/Index.cfm?CFApp=16&Message_ID=73326)
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5. Dextrose-peptone-yeast extract Agar (DPYA)
Glucose (dextrose) 5.0 g
Peptone 1.0 g
Yeast extract 2.0 g
NH4NO3 1.0 g
K2HPO4 1.0 g
MgSO4.7H2O 0.5 g
FeCl3.6H2O 0.01 g
Oxgall 5.0 g
Sodium propionate 1.0 g
Chlortetracycline 30 mg
Streptomycin 30 mg
Agar 20 g
Distilled water 1000 ml
DPYA is an excellent medium for isolating fungi from soil and other natural substrates. The oxgall and sodium propionate restrict the growth of some rapidly spreading fungi, while the chlortetracycline and streptomycin discourage bacteria.
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http://www.nursingceu.com/NCEU/courses/handtwo/
Chloroxylenol
Chloroxylenol, also known as parachlorometaxylenol (PCMX), is a compound that has been used as a preservative in cosmetics and other products and as an active agent in antimicrobial soaps. It was developed in Europe in the late 1920s and has been used in the United States since the 1950s.
The antimicrobial activity of PCMX likely is attributable to inactivation of bacterial enzymes and alteration of bacterial cell walls. It has good in vitro activity against gram-positive organisms and fair activity against gram-negative bacteria, mycobacteria (leprosy, TB), and certain viruses. PCMX is less active against P. aeruginosa, but addition of ethylene-diaminetetraacetic acid (EDTA) increases its activity against Pseudomonas spp. and other pathogens.
A limited number of articles focusing on the efficacy of PCMX-containing preparations intended for use by HCWs have been published in the last 25 years, and the results of studies have sometimes been contradictory. The disparity between published studies may be associated with the various concentrations of PCMX included in the preparations evaluated and with other aspects of the formulations tested, including the presence or absence of EDTA. PCMX is not as rapidly active as chlorhexidine gluconate or iodophors, and its residual activity is less pronounced than that observed with chlorhexidine gluconate. In 1994, FDA TFM tentatively classified PCMX as a Category IIISE active agent (i.e., insufficient data are available to classify this agent as safe and effective).
The antimicrobial activity of PCMX is minimally affected by the presence of organic matter, but it is neutralized by nonionic surfactants. PCMX, which is absorbed through the skin, is usually well-tolerated, and allergic reactions associated with its use are uncommon. PCMX is available in concentrations of 0.3%-3.75%. In-use contamination of a PCMX-containing preparation has been reported.
Triclosan
Triclosan is a nonionic, colorless substance that was developed in the 1960s. It has been incorporated into soaps for use by HCWs and the public and into other consumer products. Concentrations of 0.2%-2% have antimicrobial activity. Triclosan enters bacterial cells and affects the cytoplasmic membrane and synthesis of RNA, fatty acids, and proteins.
Triclosan has a broad range of antimicrobial activity, but it is often bacteriostatic. Minimum inhibitory concentrations (MICs) range from 0.1 to 10 ug/mL, whereas minimum bactericidal concentrations are 25-500 ug/mL. Triclosan's activity against gram-positive organisms (including MRSA) is greater than against gram-negative bacilli, particularly P. aeruginosa. The agent possesses reasonable activity against mycobacteria and Candida spp., but it has limited activity against filamentous fungi. In 1994, FDA TFM tentatively classified triclosan <1.0% as a Category IIISE active agent (i.e., insufficient data exist to classify this agent as safe and effective for use as an antiseptic handwash). Further evaluation of this agent by the FDA is underway. Like chlorhexidine, triclosan has persistent activity on the skin. Its activity in hand-care products is affected by pH, the presence of surfactants, emollients, or humectants and by the ionic nature of the particular formulation. Triclosan's activity is not substantially affected by organic matter. The majority of formulations containing <2% triclosan are well-tolerated and seldom cause allergic reactions. Certain reports indicate that providing hospital personnel with a triclosan-containing preparation for hand antisepsis has led to decreased MRSA infections. Triclosan's lack of potent activity against gram-negative bacilli has resulted in occasional reports of contamination.
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http://217.60.75.10/labsafe/labsafe/biological/disinfectants/jjmdisinfectalt.html#chlorhex
CHARACTERISTICS
- FOR THE DIFFERENT TYPES OF DISINFECTANTS:
Alcohols-aldehydes-chlorhexidine-chlorine preparations-iodine preparations-oxydizing agents-phenolics-
quaternary ammonium compounds
Name: ALCOHOLS
Ethyl alcohol (ethanol) and isopropyl alcohols are the most frequently used alcohols.
Formula:
Ethanol: CH3CH2-OH Isopropanol: CH3-CH-OH
|
Inflammable. CH3
Effect:
Alcohols kill vegetative forms of bacteria (including TB) and fungi, but have no action on spores or
viruses (there might, however, be some effect on kappebærende vira).Their effect depend on
concentration and type of alcohol.
The following three solutions have similar effect:
Ethanol 70% , isopropanol 60% and n-propanol 40%
70-80% alcohol inactivates HIV and Hepatitis B in 2-10 minutes.
How does it work:
Alcohols precipitate proteins and solubilize lipids present in cell membranes.
It has a rapid action.
Contact time should preferably be 10-30 minutes.
Toxicity:
Ethanol is absorbant and astringent and dries out the skin. Propanoles are less absorbant, but they might penetrate the skin. The brief irritant action seen on the skin , when alcohol is applied in high concentrations, results from partial precipitaion of cellular proteins and from its dehydrating actions. If strong alcohol vapours are inhaled, the irritation causes reflex closure of glottis.
Effect on other materials:
Non-corrosive
May damage rubber, shellac and plastic
Interaction:
Synergistic effect together with iodine, chlorhexidin and quaternary ammonium compounds.
Alcohols are easily inactivated by organic material.
Use:
Hands, skin and instruments and surfaces: 60-70% ethanol.
In this case the effect is not enhanced with higher concentration, as it takes water to practice its effect
Name:ALDEHYDES
Formaldehyde (FA) and Glutaraldehyde (GA)
Pungent odour.
Effect:
Very effective against all kinds of germ; spores might take longer time and fungi might take higher concentrations.
Formaldehyde and glucoxal takes at least 2-4 hours (preferably 24 hours) to exert their effect; glutaraldehyde works a little faster.
Effect depends on temperature: FA has the best effect with high temperature and high humidity. There is no effect < 12ºC. GA can be used down to 5ºC with a longer action period.
pH dependent. FA works best in a neutral environnement, whereas GA has its optimum in a weak alkaline environnement (pH 7,5-8,5)
Not sensitive to organic matter, but it has difficuties in penetrating it.
How does it work:
Alkylating agents that react with the amine, sulfhydryl and carboxyl groups af protein and small organic molecules to kill microorganims.
Toxicity:
Even high dilutions is irritant to skin, eyes and airways; higher concentrations: cauterization.
All aldehydes may cause allergy, allergic asthma and allergic contactexema.
Large concentrations give strong irritation of mucous membranes in nose and eyes plus tear flux.
Effect on other materials:
Non-corrosive
Plastic and rubber might absorb considerable amountsà might be removed by rinsing it with clean water for 2 minutes.
Use:
FA: Instruments: 1-4%
GA: Instruments/equipment/glassware: 2%
Solutions should be freshly prepared
Name: CHLORHEXIDINE
Rapidly acting disinfectant.
Effect:
Chlorhexidine is efficient against both gram+ and gram- bacteria (but Pseudomonas, Proteus and Providencia might be resistant). No effect is seen on TB, spores and vira. The effect on fungi is variable.
The bactericidal effect is enhanced by alcohol.
pH dependant - optimum is ph 5,5-7,0 but it works in the range pH 5-8. pH-values lower than 5 vil give a destruction of chlorhexidine, whereas pH values above 8 vil cause a precipitation of the chlorhexidinebase.
In the presence of inorganic iones the heavily soluable chlorhexidinesalts wil precipitate, thus reducing the available amount.
It is inactivated by cork.
How does it work:
Toxicity:
Low toxicity, but when used frequently through a longer period of time, a few cases of contact dermatitis and fotosensibilisation have been observed.
Effect on other materials:
It is inactivated by cork.
Preparations for use do not damage metals or plastics.
Use:
Skin/hands: 0,5% or 1% dissolved in alcohol
Instruments: 0,5% dissolved in alcohol
Name: CHLORINE PREPARATIONS
Rapidly acting disinfectants after a period of induction. Organic chlorine compounds have a longer period of induction as do inorganic compounds (e.g. chloramine (氯亞明) T and sodium hypochlorite (n.次氯酸鹽) ).
1 gram chlorine/liter of water = 1 gram active chlorine pr. liter
Effect:
Very efficient with rapid action on bacteria, vira and most fungi.With higher concentration and/or longer time to effect, there is effect on TB, spores and the rest of the fungi.
Maximum effect at pH =7; at pH > 8-9 the effect is strongly reduced.
When pH is falling , the stability of the solution is reduced.
Some organic chlorine preparations may have effect in the range from pH 5-10.
The efficacy is strongly reduced by organic matter - when it reacts with protein chloramines are produced; they are bactericidal, but they work very slowly.
Contact time should be 10-60 minutes.
How does it work:
The effect is caused by the undissociated chlorundersyrling
Toxicity:
Chlorine preparations mixed with acid creates very toxic vapours.
Strong solutions of hypochlorite smell unpleasantly and are toxic - use thiosulfate as antidote.
Strong solutions of hypochlorite are caustic or strongy irritant to skin, eyes and mucous membranes, whereas solutions ready for use not are irritant.
When used through a longer period of time, chlorexema may arise.
Effect on other materials:
Very corrosive, especially to aluminium, but even stainless steel is damaged.
They have a bleaching effect.
Many plastics are resistent to chlorine preparations.
Interactions:
Chlorine preparations mixed with acid creates very toxic vapours.
Use:
Inorganic chlorine preparations:
Solutions for use are unstabile and should be freshly prepared/not more than 48 hours.
Rooms/tools: 200 mg - 10g active chlorine/liter
Organic chlorine preparations:
Hands: 1000-2500 mg active chlorine/liter
Instruments: 5000 mg active chlorine/liter
Name: IODINE PREPARATIONS
Iodine and iodophors. Rapid acting disinfectants.
Iodophors is an aqueous solution where iodine is "made soluble" by means of a detergent. There is an equilibrium (n.平衡;均衡;均勢)between free iodine and complex-bound iodine. As the free iodine is used, the equilibrium is displaced and bound iodine is liberated.
Iodine dissolves poorly in water but is readily soluble in alcohol.
Effect:
It is effective against all kinds of germs. Spores and TB, however, takes higher concentrations. The effect is enhanced when they are dissolved in alcohol.
The efficacy is reduced by organic matter. 5 % serum reduces the effect 4 - 20 times.
Efficient over a wide pH range, but it has maximum effect in an acid or neutral environment. Iodophor solutions retain good bactericidal activity in the prsence of organic matter as long as pH does not go higher than 4.
Iodophors has reduced effect at pH>8.
Iodophores: The solution is brown/yellow and will loose its colour as it is inactivated.
Contact time should be 10-30 minutes.
How does it work:
Iodine preparations reacts with hydroxyl groups and inactivates proteins.
Toxicity:
Iodine: Irritating to tissue. People, who are allergic to iodine might get contact-dermatitis.
When the skin is intact iodine is only slightly absorbed, whereas damaged skin might absorb large amounts.
Iodophors are less irritating. The solutions for use is untoxic and non-irritating - but has limited durability.
Effect on other materials:
Very corrosive to metals ( not stainless steel).
Very staining on plastic and textiles.
Rubber will crumble under long influence from iodine preparations
Interaction:
Iodine preparations should not be used together with quaternary ammonium compounds as it inactivates them.
Iodophors are rapudly inactivated by contact with metals, except from stainless steel. Furthermore they are inactivated by temperatures above 35 °C (sunlight) - this can by seen as the brown colour of the solution will be reduced or disappear by the inactivation.
Use:
Iodine: Skin: 0,5-5% dissolved in 80-90% alcohol
Iodophors: Skin: 1000 mg active iodine/l
Hands: 200-500 mg active iodine/l
Instruments: 500 mg active iodine/l
Name: OXYDIZING AGENTS
E.g. Hydrogen peroxide, Peracids and chlorine dioxide
Concentrated solutions - 30-35% hydrogen peroxide and 40 % peracid - are explosive.
Effect:
Hydrogen peroxide: effect on bacteria, vira and most fungi. At higher concentrations the rest of the fungi and spores are killed.
Peracids: Kills bacteria, fungi, spores and vira. It works more rapidly and with lower concentration than hydrogen peroxide.
Efficient at low temperatures. Effect is reduced by organic matter.
Chlorine dioxide: Very efficient against all germs (fungi takes longer time). It is activated by lowering pH, which gives a rapid action
How does it work:
Gives a lethal oxydation in the microorganisms.
Toxicity:
Concentrated solutions may cause serious cauterizations on skin, eyes and mucous membranes.
Inhalation may irritate the airways and might on sight result in cronical bronchitis.
Chlorine dioxide: Low toxicity. Concentrated solutions gives no skinirritation and only slight eyeirritation.
Effect on other materials:
Peracid is corrosive on metals (especially iron, brass and copper), but is less agressive than chlorine and iodine.
Chlorine dioxide is (almost) non-corrosive.
Use:
H2O2: 3-30 % aqueous solution
Peracid: 0,001-0,3% aqueous soulution
Chlorine dioxide: Instrument disinfection and gas sterilization of germ-free animal chambers
Name: PHENOLICS
Phenol (carbolic acid), cresols and synthetical phenolderivatives have all strong bactericidal effect.
Simple phenolics have a penetrating odor, whereas higher phenolics are odourless. They are heavily degradable.
Effect:
Simple phenolics: Best effect on gram- bacteria. With higher concentration and longer time to work there will be effect on TB.
Multiple phenolics are effective against gram+ (bacteriostatic) as well as gram- bacteria.
Variable effect on fungi. No effect on spores and vira.
Rate of action varies with concentration and type of phenolic compound.
Simple phenolics are effective in the presence of organic matter, whereas multiple phenolics may have a limited activity.
Phenolics are not very temperature- and time dependent.
Contact time should be 10-30 minutes. Phenolic compounds leaves on a residual film, which may be desirable on some surfaces, but unwanted in other connections, eg. in culture systems.
How does it work:
Phenolic compounds function by denaturing and coagulating the protein within the cells. In low concentrations, phenol disrupt the cell wall, allowing leakage of cellular constituents.
Toxicity:
It is easily absorbed through skin and mucous membranes, which gives a toxic action on the kidney and Central Nervous System.
Large amounts of phenolics might be absorbed in rubber and plastic.
Short skin contact with a solution for use will normally give no skin reaction.
Concentrated solution: Short contact will give skin irritation, whereas longer skin contact will give cauterizations.
Effect on other materials:
Low corrosiveness; aluminium might be affected with alkaline pH.
Large amounts og phenols might damage rubber and plastic.
Optical instruments might be damaged
Use:
Instruments: 3-5%
Name: QUATERNARY AMMONIUM COMPOUNDS
Cationic detergents with bactericidal effect.
Effect:
Effective against Gram+ bacteria and most gram- (Pseudomonas and Serratia might be resistent - Pseudomonas might even multiply in solutions for use) When used over a longer period, there can be a selection in favour of gram- bacteria.
There is some effect on fungi, but fungi with a lipoid-layer like Fusarium are difficult to affect. There is no sporocidal and virocidal effect, as well as no effect on TB is observed.
Efficiency is reduced in the presence of organic matter.
Quaternary ammonium compounds is adsorbed to rubber, cotton and other porous matters à concentration is reduced.
It is inactivated by low pH solutions, phospholipids, organic compounds and metal ions, and therefore there is limited effectiveness in soaps, detergents and hard water salts.
The bactericidal effect is enhanced by alcohol.
The best effect is seen in a weakly alkaline environnement.
Contact time should be 10-30 minutes.
How does it work:
They contain alkyl groups that interact with membrane lipids to disrupt the cytoplasmic membrane of bacteria.
Toxicity:
Solutions for use are untoxic.
Concentrated solutions irritates eyes, skin and mucous membranes.
There has been reports of a few cases of allergy.
Lethal dose is estimated to be 1-3 grams in the form of concentrated solution in humans.
Effect on other materials:
Slightly corrosive on aluminium and iron. The corrosive effect on iron may be neutralized by the addition of 0,5% sodiumnitrit.
Rubber may get "greasy" after longer influence.
Use:
Hands: 0,1%
Skin: 0,1-0,2% dissolved in alcohol
Instruments: 1-2%
Surfaces: 0,5%
Solutions <0,5 % should be freshly prepared
_________________________________________________________________________
Our recommendations:
To summ up the above, we will close this subject by giving some recommandations for disinfectants for use in the laboratory - where no special considerations are to be taken regarding microorganisms, materials etc.
For surfaces:
Alcohol - ethanol 70%
Some chlorine preparations
Peracids (Oxydizing agents)
For hands:
Hygienic handwash - ethanol 70%
For instruments:
a. As pretreatment prior to sterilisation:
Chlorine preparations
b. As the only treatment:
Chlorine preparations
Peracids (Oxydizing agents)
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www.windrug.com/pic/10/12/19/13/010.htm - 網頁紀錄
十一烯酸 undecylenic acid
【历史】 本品为消毒防腐药，是一种含11碳在不饱和脂肪酸，由卡夫特（krafft）于1877年由减压蒸馏蓖麻油制得，1937年正式生产，我国于1958年投产。中国、美国、英国、德国、法国、意大利、瑞士等国药典均有收载。
【其他名称】 undecenoic acid；undecap。
【性状与稳定性】 十一烯酸为淡黄色至黄色液体；色泽受光与空气影响，遇冷则变成乳白色结晶性团块，有特臭，几不溶于水，能与乙醇、氯仿、乙醚、挥发油或脂肪油任意混合。凝固点不低于21℃。
【药物作用】 本品能抑制真菌的繁殖。
【适应症状】 用于治疗头癣、股癣、足癣等皮肤真菌感染及真菌性阴道炎。对脚癣的疗效最好。
【不良反应与注意事项】 局部外用可引起接触性皮炎。本品为外用药不可内服，当浓度过大时对组织有刺激性。
【用法与用量】 外用。局部涂敷其制剂，须连用数周才能治愈。用于黏膜的浓度不宜大于1％，一日2～3次。
【限定剂型】 软膏剂、外用溶液剂。
【可供选用的上市制剂】
脚气灵软膏（复方十一烯酸锌软膏），生产，每10克中含十一烯酸0.5克，十一烯酸锌2克，锌具有收敛作用，这一作用有助于减轻炎症。
十一烯酸药水（内含酒精）。
脚气灵：软膏剂，天津药业公司生产。20％，每支10克，含十一烯酸锌2克，外用，涂敷患部，一日2～3次。置于密闭、干燥处贮存。含十一烯酸、氧化锌、甘油等。
湿气灵药粉：含十一烯酸、水杨酰苯胺、薄荷油、氧化锌、麝香草酚等。
新脚气灵：软膏剂，沈阳市兴齐制药厂生产。成分十一烯酸、十一烯酸锌、皮质激素，每支10克，外用，一日2～3次，除用于皮肤癣症外，还可以用于过敏皮炎和皮肤瘙痒等。
复方十一烯酸锌软膏：软膏剂，广州何济公制药厂生产。20％，每支10克，含十一烯酸锌2克，外用，用于头癣、足癣，洗净患部后涂敷，一日2～3次。密闭贮存。
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www.lamasbeauty.com/glossary/print_P.html - 網頁紀錄
Pityriasis Alba: Seborrheic dermatitis.
Pityriasis Capitis: Dandruff.
Pityrosporum: Yeast that is a common inhabitant of the skin, usually starting at puberty. Not the yeast that causes vaginitis in women.
Pityrosporum Folliculitis: An acne-like rash composed of minute papules and pustules but no comedones (blackheads / whiteheads). It occurs most frequently on the forehead and sides of the face.
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http://web.uct.ac.za/depts/mmi/jmoodie/d01html.html#D01B
D01B ANTIFUNGALS FOR SYSTEMIC USE
Griseofulvin, certain azoles, and terbinafine are used systemically for serious or intractable dermatomycoses. Use should be restricted to the treatment of chronic infections not responding to topical measures.
Griseofulvin, an antifungal antibiotic, exerts an inhibitory action against common dermatophytes. It is inactive against yeasts and yeast-like fungi, including candida and pityrosporum species. It has no effect on fungi producing deep mycoses or on bacteria.
Terbinafine, an allylamine, is fungicidal against dermatophytes and some yeasts, but only fungistatic against C.albicans. Oral terbinafine is not effective in pityriasis versicolor.
Ketoconazole, fluconazole and itraconazole are effective for both yeast and dermatophyte infections. For full profiles, see section J02.
Intermittent therapy with itraconazole may be used for managing onychomycoses. As this agent is concentrated in the nail plate, it has been found that continuous therapy is not necessary. Ideally chemical or physical removal of the infected dystrophic nail plate should be used in conjunction with oral medication: itraconazole 200 mg/day, 1 week/month for 4 months.
Griseofulvin
(WHO essential agent)
Indications: Dermatophyte infections of the skin and appendages. Systemic administration is used for hair infections and failed topical management of all tinea infections.
Pharmacokinetics: Irregular absorption occurs over a prolonged period of time. It is deposited in keratinocytes and concentrated in the stratum corneum, nails and hair.
Absorbed drug is metabolised in the liver and excreted in urine. A large amount of an oral dose is excreted unchanged in faeces.
Precautions:
Contraindications: Liver failure; history of hypersensitivity to griseofulvin. Use with caution in systemic lupus erythematosus.
Drug interactions:
Alcohol: The effect of alcohol may be potentiated.
Antiepileptic agents: Effects of griseofulvin may be diminished.
Oral contraceptives: May result in contraceptive failure or breakthrough bleeding.
Warfarin: Anticoagulant effect may be reduced.
Pregnancy: Crosses the placenta; embryotoxic and teratogenic in animals. Avoid.
Lactation: Not known if excreted in breast milk; problems not documented.
Porphyria: Avoid
Geriatrics: Use with caution.
Paediatrics: Use is well established.
Adverse effects: Frequent - mild and transient headaches, skin rashes, GI disturbances, altered taste sensation and dry mouth.
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http://www.sim.fi/eng/products/System4/system4.html (Commercial page)
System 4
Very effective treatment for various scalp problems.
Countless users of System 4 have already found relief for conditions such as: dandruff, fungi, bacteria, yeast fungus, itching, psoriasis, atopic dermatitis, irritated skin, excessive secretion of sebaceous glands, hair loss or poor scalp microcirculation.
System 4 provides therapeutic synergy between shampoos and treatments. Not only do all the products provide individual benefits, but they also improve the effect of other System 4 products.
System 4 products include only dermatologically tested, safe raw materials.
The unique effect of System 4 is achieved using the following ingredients:
Climbazole is highly effective against one of the main causes of dandruff, the malassezia furfur fungus.
Piroctone olamine is effective against the pityrosporum fungus, another fungus causing dandruff.
Salicylic acid is an effective scalp and
keratosis exfoliater.
Undecylenic acid prevents excessive sebum secretion and calms irritated skin.
Rosemary stimulates hair growth.
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http://www.nutramed.com/skin/skinfungal.htm
ANTIFUNGAL
Imidazoles are active against dermatophyte and candida and pityrosporum infections. They also inhibits growth of some gram-positive bacteria.
Canesten, clozole, lotremin, myco-hermal, 1% clotrimazole (cr or lotion)
Daktarin, 2% miconazole cr
Dermazole, pervaryl, 1% econazole nitrate cr
Exelderm, 1 % sulconazole nitrate cr
Mycospor, 1% bifonazole cr
Travogen, 1% isoconazole cr
Trosyd, 1% tioconazole cr
10.2 Allylamine are active against dermatophyte but less effective against candia and pityrosporum infections when compared with azole derivatives.
Exoderil : 1% Naftifine HCl cr
Lamisil : 1% Terbinafine cr
10.3 Polyenes are active against candida sp but not dermatophytes.
Fungizone : 3% amphotericin B cr
Mycostatin, : 100,000 u/gm Nystatin cr
Nadostine
10.4 Miscellaneous compounds including older products that are generally less active and more irritant and newer agents that do not fall into a particular class of drugs listed above.
- Tolnaftate active againsts dermatophytes and pityriasis versicolor but not candida & bacteria.
Aftate; Scholl; : containing 1% (cr/solution/powd spray)
Tinaderm
- Ciclopiroxolamine spectrum similar to imidazole.
Batrafen : containing 1% cr
- Undecylenic acid more irrtant, ususally as an ingredient of foot powders for prophylaxis or treatment of tinea pedis.
Dagra foot powder : Zn undecylenate (salicylic acid, boric acid, hexachlorophene)
Other including : Detrisol oint, egomycol solution, mycoderm cr/powd, mycota cr/powd/spray, tineafax oint/powd, benzoderm soap
- Haloprogin is active against dermatophyte, tinea versicolor and in vitro also against staphylococci, streptococci, and candida albicans.
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http://www.mesinc.com/education/monographs2/cme023/content/11.html
ITRACONAZOLE
Itraconazole is a synthetic triazole antifungal agent that inhibits the synthesis of ergosterol, an integral constituent of the cytoplasmic membrane of fungal cells. Specifically, it inhibits the cytochrome P450 (CYP 450)-dependent 14a-demethylase and leads to an accumulation of methylated sterols such as lanosterol and, thus, a defective cell membrane with altered permeability and function.40
Spectrum of Activity
Itraconazole has a broad spectrum of in vitro activity and a high affinity for keratinized tissues, which results in high concentrations of the drug in the nail plate.11 The therapeutic activity of itraconazole has been demonstrated against infections caused by dermatophytes, Candida sp, Pityrosporum infections, and nondermatophyte molds, such as Aspergillus sp, Fusarium sp, Alternia sp, and Scopulariopsis brevicaulis.16 Itraconazole may be considered the drug of first choice in mixed infections because of this wide spectrum of activity.
Clinical Efficacy
Numerous studies demonstrating the efficacy of itraconazole for the treatment of onychomycosis have been conducted in the US and Europe in doses ranging from 100 to 600 mg/day.41,42 Pulse therapy, consisting of two pulses of 200 mg itraconazole twice daily for 1 week separated by 3 weeks off treatment is the recommended treatment regimen for fingernail onychomycosis. The FDA-approved treatment regimen for toenail infections is 200 mg once daily for 12 weeks; however, clinical research has shown that three pulses of treatment (200 mg twice daily for 1 week per month for 3 consecutive months) are as effective as continuous therapy for the treatment of toenail onychomycosis, and this has become the standard of care.30,31
Pooled data (14 studies; 1389 patients)41 indicate that three pulses of itraconazole for the treatment of dermatophyte toenail onychomycosis result in clinical cure, clinical response, mycologic cure rates, and relapse rates of 58%, 82%, 77%, and 10%, respectively, 12 months after the start of therapy. Similarly, two pulses of itraconazole for the treatment of fingernail onychomycosis result in clinical cure, clinical response, mycologic cure rates, and relapse rates of 78%, 89%, 77%, and 4.9%, respectively, 9 months after the start of therapy
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www.aafp.org/afp/20031115/1963.html - 網頁紀錄
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http://www.interpharmaplus.com/product.php?p=179
Product Information
Nizoral (Ketoconazole) cream Box with tube with 40 g
Active Ingredient:
Ketoconazol 2g
Directions:
NIZORAL Cream is indicated
in the treatment of the infections
in the skin:
membranes due to Trichophyton mentagrophytes,
Microsporum canis and Epidermophyton floccosum, like in the
treatment of the nea candidosis , vulvitis and
pitiriasis.
indicated in the treatment of the
seborreica dermatitis when the presence of Pityrosporum is
demonstrated makes oval.
Warning:
Cream is not for oftálmic use. In order to prevent the effect it
bounces after suspending a treatment prolonged with corticosteroides
topical, is recommendable to continue with the application of a
moderate topical corticoesteroide in the mornings and to apply to
NIZORAL * cream in, afternoon subsequent and gradually retiring the
therapy with steroids in a period of 2-3 weeks.
In Stock
Price: $19.99 Shipping: Click to see our rates
Handling: $0.00
---------
http://www.ecureme.com/emyhealth/Pediatrics/Cradle_Cap.asp
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http://archderm.ama-assn.org/cgi/content/abstract/112/3/350
Clinical evaluation of clotrimazole. A broad-spectrum antifungal agent
P. H. Spiekermann and M. D. Young
The efficacy and safety of the broad-spectrum, topically applied antifungal agent clotrimazole were evaluated in two double-blind, multicentric trials. Ten investigators reported on a total of 1,361 cases in which a 1% solution or a 1% cream formulation was compared with its respective vehicle. Clotrimazole was therapeutically effective, as confirmed by mycological cure (negative microscopy and culture) and clinical improvement, in tinea pedis, tinea cruris, tinea corporis, pityriasis versicolor, and cutaneous candidasis. Furthermore, species identification established the efficacy of clotrimazole against Trichophyton rubrum, T mentagrophytes, Epidermophyton floccosum, Microsporum canis, Malassezia furfur (Pityrosporum orbiculare), and Candida albicans. Safety was demonstrated by the low incidence of possibly drug-related adverse experiences, namely, 19 (2.7%) of 699 patients who were treated with clotrimazole, of whom four (0.6%) discontinued treatment.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
----------------
The PASCO antifungal susceptibility test system, developed in collaboration with a commercial company, is a broth microdilution assay which is faster and easier to use than the reference broth microdilution test performed according to the National Committee for Clinical Laboratory Standards (NCCLS) document M27-A guidelines. Advantages of the PASCO system include the system's inclusion of quality-controlled, premade antifungal panels containing 10, twofold serial dilutions of drugs and a one-step inoculation system whereby all wells are simultaneously inoculated in a single step. For the prototype panel, we chose eight antifungal agents for in vitro testing (amphotericin B, flucytosine, fluconazole, ketoconazole, itraconazole, clotrimazole, miconazole, and terconazole) and compared the results with those of the NCCLS method for testing 74 yeast isolates (14 Candida albicans, 10 Candida glabrata, 10 Candida tropicalis, 10 Candida krusei, 10 Candida dubliniensis, 10 Candida parapsilosis, and 10 Cryptococcus neoformans isolates). The overall agreements between the methods were 91% for fluconazole, 89% for amphotericin B and ketoconazole, 85% for itraconazole, 80% for flucytosine, 77% for terconazole, 66% for miconazole, and 53% for clotrimazole. In contrast to the M27-A reference method, the PASCO method classified as resistant seven itraconazole-susceptible isolates (9%), two fluconazole-susceptible isolates (3%), and three flucytosine-susceptible isolates (4%), representing 12 major errors. In addition, it classified two fluconazole-resistant isolates (3%) and one flucytosine-resistant isolate (1%) as susceptible, representing three very major errors. Overall, the agreement between the methods was greater than or equal to 80% for four of the seven species tested (C. dubliniensis, C. glabrata, C. krusei, and C. neoformans). The lowest agreement between methods was observed for miconazole and clotrimazole and for C. krusei isolates tested against terconazole. When the data for miconazole and clotrimazole were removed from the analysis, agreement was 80% for all seven species tested. Therefore, the PASCO method is a suitable alternative procedure for the testing of the antifungal susceptibilities of the medically important Candida spp. and C. neoformans against a range of antifungal agents with the exceptions only of miconazole and clotrimazole and of terconazole against C. krusei isolates.
--------------
http://www.peacehealth.org/kbase/multum/d01236t1.htm
clotrimazole topical
Pronunciation: kloe TRIM a zole
Brand: Desenex AF Prescription Strength, Fungoid Solution, Lotrimin, Lotrimin AF, Lotrimin Jock Itch Powder, Mycelex, Mycelex OTC
What is the most important information I should know about clotrimazole topical?
Use this medication for the full amount of time prescribed by your doctor or as recommended in the package even if you begin to feel better. Your symptoms may improve before the infection is completely healed.
Do not use bandages or dressings that do not allow air to circulate to the affected area (occlusive dressings) unless otherwise directed by your doctor. Wear loose-fitting clothing (preferably cotton).
Avoid getting this medication in your eyes, nose, or mouth.
What is clotrimazole topical?
Clotrimazole topical is an antifungal medication. Clotrimazole topical prevents fungus from growing on your skin.
Clotrimazole topical is used to treat skin infections such as athlete's foot, jock itch, ringworm, and yeast infections.
Clotrimazole topical may also be used for purposes other than those listed in this medication guide.
Who should not use clotrimazole topical?
Do not use clotrimazole topical if you have had an allergic reaction to it in the past.
Clotrimazole topical is in the FDA pregnancy category B. This means that it is unlikely to harm an unborn baby. Do not use clotrimazole topical without first talking to your doctor if you are pregnant.
It is not known whether clotrimazole passes into breast milk. Do not use clotrimazole topical without first talking to your doctor if you are breast-feeding a baby.
How should I use clotrimazole topical?
Use clotrimazole topical exactly as directed by your doctor or follow the directions that accompany the package. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
Wash your hands before and after using this medication, unless you are using it to treat a hand infection.
Clean and dry the affected area. Apply a small amount of the cream (usually twice daily) for 2 to 4 weeks.
Do not take this medication by mouth.
If the infection does not clear up in 4 weeks, or if it appears to get worse, see your doctor.
Use this medication for the full amount of time prescribed by your doctor or as recommended in the package even if you begin to feel better. Your symptoms may improve before the infection is completely healed.
Do not use bandages or dressings that do not allow air circulation over the affected area (occlusive dressings) unless otherwise directed by your doctor. A light cotton-gauze dressing may be used to protect clothing.
Avoid getting this medication in your eyes, nose, or mouth.
Store clotrimazole topical at room temperature away from moisture and heat.
What happens if I miss a dose?
Apply the missed dose as soon as you remember. However, if it is almost time for your next regularly scheduled dose, skip the dose you missed and apply only the regular amount of clotrimazole topical. Do not use a double dose unless otherwise directed by your doctor.
What happens if I overdose?
An overdose of clotrimazole topical is unlikely to occur. If you do suspect that a much larger than normal dose has been used, or that clotrimazole topical has been ingested, contact an emergency room or a poison control center.
What should I avoid while using clotrimazole topical?
Avoid wearing tight-fitting, synthetic clothing that doesn't allow air circulation. Wear clothing made of loose cotton and other natural fibers until the infection is healed.
What are the possible side effects of clotrimazole topical?
Serious side effects of clotrimazole topical use are not expected. Stop using clotrimazole topical and see your doctor if you experience unusual or severe blistering, itching, redness, peeling, dryness, swelling, or irritation of the skin.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect clotrimazole topical?
Avoid using other topicals at the same time unless your doctor approves. Other skin medications may affect the absorption or effectiveness of clotrimazole topical.
Drugs other than those listed here may also interact with clotrimazole topical. Talk to your doctor and pharmacist before taking or using any other prescription or over-the-counter medicines.
Where can I get more information?
Your pharmacist has additional information about clotrimazole topical written for health professionals that you may read.
What does my medication look like?
Clotrimazole topical is available under the brand name Lotrimin for prescription products and under the brand name Lotrimin AF for over-the-counter products. Other brand or generic formulations may also be available. Clotrimazole topical is available as a cream, a solution, and a lotion. Ask your pharmacist any questions you have about this medication, especially if it is new to you.
-----------
http://www.inhousedrugstore-europe.com/infections/daktarin.html (Commercial)
Daktarin Oral Gel - an overview
Uses:
DAKTARIN oral gel is indicated for the treatment of clinically significant oral and gastrointestinal candidiasis "Oral Trush". Miconazole possesses an antifungal activity against the common dermatophytes and yeasts as well as an antibacterial activity against certain gram-positive bacilli and cocci. Its activity is based on the inhibition of the ergosterol biosynthesis in fungi and the change in the composition of the lipid components in the membrane, resulting in fungal cell necrosis.
Dosage and Administration
Infants :
For infants less than one year old, one quarter (? of a measuring spoon* of gel four times daily, or 20 mg/kg/day is recommended.
Children and Adults :
Half (? a measuring spoon* of gel four times daily.
* A measuring spoon (5 mL) is provided with the gel. One spoonful contains approximately 124 mg of miconazole.
All spoonful dose volumes should be administered with this spoon .
DAKTARIN oral gel should be placed on the tongue and kept in mouth for as long as possible before swallowing.
When treating infants and younger children it is recommended that the measured dose of gel be given in several portions in the front of the mouth.
Avoid dosing to the back of the throat to prevent obstruction.
With oral thrush in elderly patients where a contributing cause is the dental prosthesis, it is recommended that DAKTARIN oral gel be applied directly to the dentures in the evening and left on overnight.
The treatment should be continued for at least one week after the symptoms have disappeared and generally until all clinical and mycological laboratory tests no longer indicate that active fungal infection is present.
Contraindications
DAKTARIN oral gel is contraindicated in patients with known hypersensitivity to any of its components and in patients with liver dysfunction.
-----------------
http://www.anti-aging-drugs.com/?chapter=nizoral
Why is this drug prescribed?
Nizoral, a broad-spectrum antifungal drug available in tablet form, may be given to treat several fungal infections within the body, including oral thrush and candidiasis.
It may also be given to treat severe, hard-to-treat fungal skin infections that have not cleared up after treatment with creams or ointments, or the oral drug griseofulvin (Fulvicin, Grisactin).
Most important fact about this drug
In some people, Nizoral may cause serious or even fatal damage to the liver. Before starting to take Nizoral, and at frequent intervals while you are taking it, you should have blood tests to evaluate your liver function. Tell your doctor immediately if you experience any signs or symptoms that could mean liver damage: these include unusual fatigue, loss of appetite, nausea or vomiting, jaundice, dark urine, or pale stools.
How should you take this medication?
Take Nizoral exactly as prescribed.
You should keep taking the drug until tests show that your fungal infection has subsided. If you stop too soon, the infection might return.
You may want to take Nizoral Tablets with meals to avoid stomach upset.
Avoid alcohol and do not take with antacids. If antacids are necessary, you should wait 2 to 3 hours before taking them.
--If you miss a dose...
Take the forgotten dose as soon as you remember. This will help to keep the proper amount of medicine in the body. However, if it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take double doses.
--Storage instructions...
Nizoral should be stored at room temperature.
What side effects may occur?
Side effects from Nizoral cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Nizoral.
More common side effects may include:
Nausea, vomiting
Less common side effects may include:
Abdominal pain, itching
Rare side effects may include:
Breast swelling (in men), depression, diarrhea, dizziness, drowsiness, fever and chills, headache, hives, impotence, light-sensitivity, rash
--------------------------
http://www.medsafe.govt.nz/Profs/datasheet/n/Nizoralcr.htm
NIZORAL*
ketoconazole 2% Cream
Presentation
NIZORAL Cream contains the synthetic broad-spectrum anti-fungal agent, ketoconazole. Each gram contains 20mg ketoconazole. The cream formulation consists of propylene glycol, stearyl alcohol, cetyl alcohol, sorbitan stearate, polysorbate, isopropyl myristate, sodium sulphite and purified water
Uses
Actions
Ketoconazole, a synthetic imidazole dioxolane derivative, has a potent antimycotic activity against dermatophytes such as Trichophyton sp., Epidermophyton floccosum and Microsporum sp. and against yeasts. In particular the effect on Pityrosporum sp. is very pronounced.
Usually ketoconazole cream acts very rapidly on pruritus which is commonly seen in dermatophyte and yeast infections as well as skin conditions associated with the presence of Pityrosporum sp. This symptomatic improvement is observed before the first signs of healing are observed.
Pharmacokinetics
NIZORAL Cream does not produce detectable blood levels after topical application.
Indications
NIZORAL Cream is indicated for topical application in the treatment of dermatophyte infections of the skin; tinea corporis, tinea cruris, tinea manus and tinea pedis due to Trichophyton rubrum, Trichophyton mentagrophytes, Microsporum canis and Epidermophyton floccosum, as well as in the treatment of cutaneous candidiasis and tinea (pityriasis) versicolor. NIZORAL Cream is also indicated for the treatment of seborrhoeic dermatitis, a skin condition associated with the presence of Pityrosporum ovale.
Overdosage
Excessive topical application may lead to erythema, oedema and a burning sensation, which will disappear upon discontinuation of the treatment. No special measures have to be taken in case of accidental ingestion.
-------------
http://www.ctclconsult.com/pdrdruginfo/html/49950620.htm
PDR® entry for
Nizoral 2% Shampoo (McNeil Consumer)
DESCRIPTION
NIZORAL® (ketoconazole) 2% Shampoo is a red-orange liquid for topical application, containing the broad-spectrum synthetic antifungal agent ketoconazole in a concentration of 2% in an aqueous suspension. It also contains: coconut fatty acid diethanolamide, disodium monolauryl ether sulfosuccinate, F.D. & C. Red No. 40, hydrochloric acid, imidurea, laurdimonium hydrolyzed animal collagen, macrogol 120 methyl-glucose dioleate, perfume bouquet, sodium chloride, sodium hydroxide, sodium lauryl ether sulfate, and purified water.
Ketoconazole is cis-1-acetyl-4-[4-[[2-(2,4-di-chlorophenyl)-2-(1H-imidazol-1-ylmethyl)-1,3-dioxolan-4-yl]methoxy]phenyl]piperazine.
Microbiology: NIZORAL® (ketoconazole) is a broad-spectrum synthetic antifungal agent which inhibits the growth of the following common dermatophytes and yeasts by altering the permeability of the cell membrane: dermatophytes: Trichophyton rubrum, T. mentagrophytes, T. tonsurans, Microsporum canis, M. audouini, M. gypseum and Epidermophyton floccosum; yeasts: Candida albicans, C. tropicalis, Pityrosporum ovale (Malassezia ovale) and Pityrosporum orbiculare (M. furfur). Development of resistance by these microorganisms to ketoconazole has not been reported.
-----
http://www.hkmj.org.hk/skin/commerci.htm
3. SHAMPOO
Nizoral shampoo: ketoconazole 2%
Polytar liquid: tar 0.3%, cade oil 0.3%, coal tar 0.1%, arachis oil extr of crude coal tar 0.3%, oleyl alcohol 1%
12. ANTIFUNGAL
12.1. Imidazoles are active against dermatophyte, candida and pityrosporum infections. They also inhibit the growth of some gram-positive bacteria.
Canesten: clotrimazole 1%
Clozole: clotrimazole 1%
Daktarin: miconazole 2%
Dermazole: econazole 15
Exelderm: sulconazole nitrate 1%
Lotremin: clotrimazole 1%
Myco-hermal: clotrimazole 1%
Mycospor: bifonazole 1%
Pervaryl: econazole 1%
Travogen: isoconazole 1%
Trosyd: tioconazole 1%
12.2. Allylamine are active against dermatophyte but less effective against candida and pityrosporum infection as compared to the azole derivatives.
Exoderil: naftifine HCl 1%
Lamisil: terbinafine 1%
12.3. Polyenes are active against candida sp but not dermatophytes.
Fungizone: amphotericin B 3%
Mycostatin: nystatin 100,000 iu per gm
Nadostine: nystatin 100,000 iu per gm
12.4. Miscellaneous compounds including older products that are generally less active and more irritant than newer agents that do not fall into a particular class of drugs listed above.
- Tolnaftate is active against dermatophytes and pityrosporum ovale but not candida and bacteria.
Aftate/Scholl/Tinaderm contain 1% tolnaftate in the form of cream, solution, powder and powder spray that can be bought over the counter.
- Ciclopirox-olamine has a spectrum similar to imidazoles.
Batrafen: ciclopirox-olamine 1%
- Undecyclenic acid/Zn undecylenate are more irritant, usually as an ingredient of foot powders for prophylaxis or treatment of tinea pedis.
Dagra foot powder: zn undecylenate (salicylis acid, boric acid, hexachlorphene)
Other including: detrisol oint, egomycol solution, mycoderm cr/powd, mycota cr/powd/spray, tineafax oint/powd, benzoderm soap
- Haloprogin is active against dermatophyte, pityrosporum and in vitro also against staphylococci, streptococci, and candida albicans.
Polik: haloprogin 1% sol
- Tolciclate has a spectrum similar to imidazoles.
Tolmicen: tolciclate 1% cr/lotion, 0.5% powd
---------------
http://web.uct.ac.za/depts/mmi/jmoodie/d11html.html
---D11AC Medicated shampoos ---
Imidazoles, e.g. ketoconazole and econazole, are useful for managing pityrosporum-related problems, e.g. tinea versicolor and seborrhoeic dermatitis. See section D01 (Nizshampoo? Pevaryl?foaming solution; also Selsun?.
----------------
http://www.jcaai.org/param/Eczema/Infect.htm
Infectious Agents
Skin infections, particularly with Staphylococcus aureus, can be a recurrent problem in atopic dermatitis requiring specific treatment. (37) Anti-staphylococcal antibiotics may be very helpful in the treatment of patients who are heavily colonized with S. aureus. (38) Erythromycin and the newer macrolide antibiotics (azithromycin & clarithromycin) are usually beneficial and safe for patients who are not colonized with a resistant S. aureus strain. In patients with macrolide-resistant S. aureus, a penicillinase-resistant penicillin (dicloxacillin, oxacillin, or cloxacillin) may be preferred. First generation cephalosporins also offer effective coverage for both staphylococci and streptococci. All macrolide antibiotics, if administered with either terfenadine or astemizole, have the potential to alter the electrocardiogram and provoke cardiac arrhythmias (torsades des pointes) in patients. Topical mupirocin may offer some utility in the treatment of impetiginized lesions (39); however, in patients with extensive superinfection, a course of systemic antibiotics is preferred.
Herpes simplex can occasionally provoke recurrent dermatitis in patients with atopy, and may be misdiagnosed as a staphylococcal infection. When vesiculation is present or when infected skin lesions fail to respond to oral antibiotics, the physician should suspect the possibility of herpes simplex infection. This can be diagnosed by a Giemsa-stained Tzanck smear of cells scraped from the vesicle base or by viral culture. Herpes simplex infections may be localized or become disseminated (Kaposi's varicelliform eruption) in patients with atopic dermatitis. Antiviral treatment for cutaneous herpes simplex infections is of critical importance in the patient with widespread atopic dermatitis since life threatening dissemination has been reported. (40,41) Acyclovir, 400 mg three times daily for ten days or 200 mg four times daily for ten days by oral administration, is useful in adults with herpes simplex confined to the skin. The dosage should be adjusted according to the weight in children.
Dermatophyte infections can complicate atopic dermatitis and may contribute to exacerbation of disease activity. Elevated serum IgE levels to both trichophytic antigens and to Pityrosporum ovale, a lipophilic yeast, have been reported. (42-44) A pathogenic contribution from dermatophyte (45) and P. ovale (45) infections is suggested by improvement of atopic dermatitis in infected patients following treatment with antifungal agents. Infestation with scabies should also be considered in the differential diagnosis of flaring atopic dermatitis, and can be diagnosed with skin scrapings examined under the microscope.
--------------------------------
http://education.vetmed.vt.edu/Curriculum/VM8784/AbxSuscept.htm
TETRACYCLINES
TETRACYCLINES CHLORTETRACYCLINE, OXYTETRACYCLINE, TETRACYCLINE, DOXYCYCLINE, MINOCYCLINE
Differences between the tetracyclines is a matter of solubility (hence pharmacokinetics, tissue penetration, etc.) rather than susceptibility.
Good Gram (+) aerobes: Bacillus sp., Corynebacterium sp., E. rhusiopathiae, L. monocytogenes, streptococci. Gram (-) bacteria: Actinobacillus sp., Bordetella sp. ,Brucella sp., F. tularensis, Haemophilus sp., P. multocida, Yersinia sp., Campylobacter fetus, Borrelia sp., Leptospira sp. Anaerobes: Actinomyces sp., Fusobacterium sp. also: Mycoplasma sp., Chlamydia sp. (including C. psittaci), Rickettsia sp., (inluding C. burnetii, Ehrlichia sp., and protozoa (Theileria, Eperythrozoon, and Anaplasma).
Variable acquired resistance in staphylococci, enterococci, Enterobacteriaceae. Anaerobes such as Bacteroides sp., and Clostridium sp., some Mycoplasma sp. (M. bovis, M. hyopneumoniae are resistant)
Resistant Mycobacterium sp., P. vulgaris, P. aeruginosa, Serratia sp.
ANTIFUNGAL DRUGS
TOPICAL ANTIFUNGAL DRUGS NATAMYCIN, NYSTATIN, CLOTRIMAZOLE, MICONAZOLE
NATAMYCIN
Good wide range of filamentous and dimorphic fungi, yeasts. Including Taenea, Candidia, Fusarium, Aspergillus
NYSTATIN
Good Candida, Pityrosporum, Cryptococcus, dermatophytes, some filamentous fungi and some dimorphic fungi. Prototheca
Resistance several Candida sp. other than C. albicans.
AZOLE ANTIBIOTICS CLOTRIMAZOLE, MICONAZOLE
Good wide range of filamentous fungi, including Aspergillus and dermatophytes, yeasts and dimorphic fungi. Malassezia
SYSTEMIC ANTIFUNGAL DRUGS GRISEOFULVIN, AMPHOTERICIN B, FLUCYTOSINE, AZOLE COMPOUNDS
GRISEOFULVIN
Good all dermatophytes
Resistance all other hyphal fungi, yeasts, dimorphic fungi and bacteria
AMPHOTERICIN B
Good in decreasing order of susceptibility: Blastomyces dermatitidis, Histoplasma capsulatum, Cryptococcus neoformans, Candida spp., Sporothrix schenckii, Coccidioides immitis, Aspergillus. many yeasts are also susceptible as is Prototheca.
Resistance some resistant Candida, C. immitis, Mucor, Aspergillus
FLUCYTOSINE
Good C. neoformans, Candida sp., Torulopsis, Cladosporium a few Aspergillus.
Resistance Dermatophytes, filamentous fungi, and dimorphic fungi. Most yeast isolates from bovine mastitis are resistant.
AZOLE ANTIFUNGAL DRUGS KETOCONAZOLE, ITRACONAZOLE, FLUCONAZOLE
KETOCONAZOLE
Good wide range of filamentous fungi (including dermatophytes), yeasts, dimorphic fungi. C. albicans, Malessezia canis, some Aspergillus.
Resistance some acquired resistance reported, some Aspergillus are resistant. Prototheca are resistant in vitro but respond in vivo. C. tropicalis is resistant.
ITRACONAZOLE
Good in addition to organisms susceptible to ketoconazole: dimorphic fungi, Cryptococcus, Sporothrix, Alternaria, most Aspergillus, C. tropicalis
Variable Candida sp., dermatophytes.
FLUCONIZOLE
Good probably similar to ketoconazole. Still being evaluated.
IODIDES
Iodides have been used for years to treat mycotic infections. Efficacy has never clearly been documented. Often included with other antifungal therapies.
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http://www.jac.oupjournals.org/cgi/content/full/43/4/579
Fungi and media
All fungi were from the SmithKline Beecham culture collection and were maintained on slopes of Sabouraud's dextrose agar (SDA, Lab M, Bury, UK) and grown in Sabouraud's liquid medium (SDB, Lab M) or synthetic Yeast Nitrogen Base (YNB, Difco, West Molesey, UK) unless stated otherwise. Pityrosporum (Malasezzia) ovale and Pityrosporum orbiculare were cultivated on a medium containing glycerol monostearate, olive oil and Tween 80.6 To facilitate incorporation studies, Trichophyton mentagrophytes was also grown in the synthetic glucose- glutamic acid- salts medium (GGS) of Kole & Bose,7 solidified, where necessary, with 2% agar. Candida albicans,Cryptococcus neoformansand Aspergillus niger were incubated at 37°C and other species at 30°C.
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http://dermnetnz.org/fungal/pityrosporum-folliculitis.html Picture for pityrosporum
-----------------
http://www.emedicine.com/derm/topic338.htm
Background: Pityrosporum folliculitis (PF) is a common condition in young or middle-aged adults that involves follicular papulopustules on the upper trunk. Weary et al first described PF in 1969, and Potter et al identified PR as a separate clinical and histologic diagnosis in 1973.
The pathogenic agents in PF are yeasts from the genus Pityrosporum?em>Pityrosporum orbiculare and Pityrosporum ovalehich are collectively known as Malassezia furfur. Lesions are chronic, erythematous, pruritic papules and pustules, which occur in a follicular pattern. These lesions usually are present on the back and chest and, occasionally, on the neck, shoulder, upper arm, and face.
Malassez first described P ovale yeasts in 1874 from scales in seborrheic dermatitis. He coined the phrases "bottle bacillus of Unna" to describe the small oval cells in the scale and "spore of Malassez" to name the bud that is observed in association with the yeast.
Because of controversy and confusion of the grouping of various lipophilic yeasts and fungi of the skin, the 2 yeast species, collectively with fungal forms, are classified as M furfur. This grouping has simplified the classification to one name, which applies regardless of the morphology of the organism.
The diagnosis of PF is based on clinical suspicion and the classic presentation of a follicular pattern of papulopustules on the trunk, with either demonstrable M furfur yeast forms or an improvement in the lesions with empiric antiyeast therapy.
Pathophysiology:
search by tricolsan spore - www.infectioncontroltoday.com/articles/321bpract.html
Date: September 19, 2003 01:49 PM
Author: Marilynn
Subject: Olive Leaf extract
I have had really good experiences with Olive Leaf. I use the Roex brand (roex.com) It is pharmaceutical grade and contains 17 to 22% oleuropean (depending on the time of year it is harvested) which is the active ingredient. I have looked for others, but only found ones that were 6% oleuopean - I am sure there are others, I just haven't hunted hard enough, but since I am satisfied with Roex, its okay. We keep it on hand and if taken every four hours at the very first sign of anything, generally stops it cold within a day. If you get something and it gets started, it will not stop it but will reduce the time you are miserable. My brother has Hepatitis C and we have been using the olive leaf (it has the ability to shred the protein covering on viruses) along with MG beta glucan from NSC (nsc24.com)(this one does not reaggregate in the intestines and it modulates the immune system), also a lot of other supplements aimed at the liver. He was keeping the viral load slowed down but still raising steadily each year until he added the olive leaf and beta glucan, which seems to have been the one two punch. His viral load is now reducing steadily for the last two years.
(http://www.agora-inc.com/forums/Index.cfm?CFApp=16&Message_ID=73457)
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Date: September 10, 2003 03:28 PM
Author: Denise
Subject: Olive leaf - BUMP UP!!
Here's the thread
(http://www.agora-inc.com/forums/Index.cfm?CFApp=16&Message_ID=71142)
--------------------------------------------------------------------------------
Date: September 18, 2003 11:05 PM
Author: Lyn
Subject: anti-bacterial, viral, fungal
In addition to olive leaf, I have found a good natural antiviral, bacterial & fungal to be Tea Tree Oil - readily available in Australia but I believe also available overseas. Green tea is also excellent - both internally and topically for minor infections and of course apple cider vinegar. In addition to taking a little internally - I also use it to wash with as I have very sensitive skin and have a bad reaction to soap. I have not had any problems since starting to use cider vinegar instead of soap. If your skin problem is sensitivity due to dryness and not an infection, then aloe vera jelly applied topically followed by a light application of blended cold pressed oils - e.g. wheat germ, macadamia, evening primrose,& a little lavender and calendula while skin is damp should help. Since using this regime which I developed by trial and error, I have received many compliments on my skin - I am in my 50's. Also take L-cysteine which boosts the immune system and is anti-bacterial and anti-viral.
(http://www.agora-inc.com/forums/Index.cfm?CFApp=16&Message_ID=73326)
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5. Dextrose-peptone-yeast extract Agar (DPYA)
Glucose (dextrose) 5.0 g
Peptone 1.0 g
Yeast extract 2.0 g
NH4NO3 1.0 g
K2HPO4 1.0 g
MgSO4.7H2O 0.5 g
FeCl3.6H2O 0.01 g
Oxgall 5.0 g
Sodium propionate 1.0 g
Chlortetracycline 30 mg
Streptomycin 30 mg
Agar 20 g
Distilled water 1000 ml
DPYA is an excellent medium for isolating fungi from soil and other natural substrates. The oxgall and sodium propionate restrict the growth of some rapidly spreading fungi, while the chlortetracycline and streptomycin discourage bacteria.
-----
http://www.nursingceu.com/NCEU/courses/handtwo/
Chloroxylenol
Chloroxylenol, also known as parachlorometaxylenol (PCMX), is a compound that has been used as a preservative in cosmetics and other products and as an active agent in antimicrobial soaps. It was developed in Europe in the late 1920s and has been used in the United States since the 1950s.
The antimicrobial activity of PCMX likely is attributable to inactivation of bacterial enzymes and alteration of bacterial cell walls. It has good in vitro activity against gram-positive organisms and fair activity against gram-negative bacteria, mycobacteria (leprosy, TB), and certain viruses. PCMX is less active against P. aeruginosa, but addition of ethylene-diaminetetraacetic acid (EDTA) increases its activity against Pseudomonas spp. and other pathogens.
A limited number of articles focusing on the efficacy of PCMX-containing preparations intended for use by HCWs have been published in the last 25 years, and the results of studies have sometimes been contradictory. The disparity between published studies may be associated with the various concentrations of PCMX included in the preparations evaluated and with other aspects of the formulations tested, including the presence or absence of EDTA. PCMX is not as rapidly active as chlorhexidine gluconate or iodophors, and its residual activity is less pronounced than that observed with chlorhexidine gluconate. In 1994, FDA TFM tentatively classified PCMX as a Category IIISE active agent (i.e., insufficient data are available to classify this agent as safe and effective).
The antimicrobial activity of PCMX is minimally affected by the presence of organic matter, but it is neutralized by nonionic surfactants. PCMX, which is absorbed through the skin, is usually well-tolerated, and allergic reactions associated with its use are uncommon. PCMX is available in concentrations of 0.3%-3.75%. In-use contamination of a PCMX-containing preparation has been reported.
Triclosan
Triclosan is a nonionic, colorless substance that was developed in the 1960s. It has been incorporated into soaps for use by HCWs and the public and into other consumer products. Concentrations of 0.2%-2% have antimicrobial activity. Triclosan enters bacterial cells and affects the cytoplasmic membrane and synthesis of RNA, fatty acids, and proteins.
Triclosan has a broad range of antimicrobial activity, but it is often bacteriostatic. Minimum inhibitory concentrations (MICs) range from 0.1 to 10 ug/mL, whereas minimum bactericidal concentrations are 25-500 ug/mL. Triclosan's activity against gram-positive organisms (including MRSA) is greater than against gram-negative bacilli, particularly P. aeruginosa. The agent possesses reasonable activity against mycobacteria and Candida spp., but it has limited activity against filamentous fungi. In 1994, FDA TFM tentatively classified triclosan <1.0% as a Category IIISE active agent (i.e., insufficient data exist to classify this agent as safe and effective for use as an antiseptic handwash). Further evaluation of this agent by the FDA is underway. Like chlorhexidine, triclosan has persistent activity on the skin. Its activity in hand-care products is affected by pH, the presence of surfactants, emollients, or humectants and by the ionic nature of the particular formulation. Triclosan's activity is not substantially affected by organic matter. The majority of formulations containing <2% triclosan are well-tolerated and seldom cause allergic reactions. Certain reports indicate that providing hospital personnel with a triclosan-containing preparation for hand antisepsis has led to decreased MRSA infections. Triclosan's lack of potent activity against gram-negative bacilli has resulted in occasional reports of contamination.
---------------------
http://217.60.75.10/labsafe/labsafe/biological/disinfectants/jjmdisinfectalt.html#chlorhex
CHARACTERISTICS
- FOR THE DIFFERENT TYPES OF DISINFECTANTS:
Alcohols-aldehydes-chlorhexidine-chlorine preparations-iodine preparations-oxydizing agents-phenolics-
quaternary ammonium compounds
Name: ALCOHOLS
Ethyl alcohol (ethanol) and isopropyl alcohols are the most frequently used alcohols.
Formula:
Ethanol: CH3CH2-OH Isopropanol: CH3-CH-OH
|
Inflammable. CH3
Effect:
Alcohols kill vegetative forms of bacteria (including TB) and fungi, but have no action on spores or
viruses (there might, however, be some effect on kappebærende vira).Their effect depend on
concentration and type of alcohol.
The following three solutions have similar effect:
Ethanol 70% , isopropanol 60% and n-propanol 40%
70-80% alcohol inactivates HIV and Hepatitis B in 2-10 minutes.
How does it work:
Alcohols precipitate proteins and solubilize lipids present in cell membranes.
It has a rapid action.
Contact time should preferably be 10-30 minutes.
Toxicity:
Ethanol is absorbant and astringent and dries out the skin. Propanoles are less absorbant, but they might penetrate the skin. The brief irritant action seen on the skin , when alcohol is applied in high concentrations, results from partial precipitaion of cellular proteins and from its dehydrating actions. If strong alcohol vapours are inhaled, the irritation causes reflex closure of glottis.
Effect on other materials:
Non-corrosive
May damage rubber, shellac and plastic
Interaction:
Synergistic effect together with iodine, chlorhexidin and quaternary ammonium compounds.
Alcohols are easily inactivated by organic material.
Use:
Hands, skin and instruments and surfaces: 60-70% ethanol.
In this case the effect is not enhanced with higher concentration, as it takes water to practice its effect
Name:ALDEHYDES
Formaldehyde (FA) and Glutaraldehyde (GA)
Pungent odour.
Effect:
Very effective against all kinds of germ; spores might take longer time and fungi might take higher concentrations.
Formaldehyde and glucoxal takes at least 2-4 hours (preferably 24 hours) to exert their effect; glutaraldehyde works a little faster.
Effect depends on temperature: FA has the best effect with high temperature and high humidity. There is no effect < 12ºC. GA can be used down to 5ºC with a longer action period.
pH dependent. FA works best in a neutral environnement, whereas GA has its optimum in a weak alkaline environnement (pH 7,5-8,5)
Not sensitive to organic matter, but it has difficuties in penetrating it.
How does it work:
Alkylating agents that react with the amine, sulfhydryl and carboxyl groups af protein and small organic molecules to kill microorganims.
Toxicity:
Even high dilutions is irritant to skin, eyes and airways; higher concentrations: cauterization.
All aldehydes may cause allergy, allergic asthma and allergic contactexema.
Large concentrations give strong irritation of mucous membranes in nose and eyes plus tear flux.
Effect on other materials:
Non-corrosive
Plastic and rubber might absorb considerable amountsà might be removed by rinsing it with clean water for 2 minutes.
Use:
FA: Instruments: 1-4%
GA: Instruments/equipment/glassware: 2%
Solutions should be freshly prepared
Name: CHLORHEXIDINE
Rapidly acting disinfectant.
Effect:
Chlorhexidine is efficient against both gram+ and gram- bacteria (but Pseudomonas, Proteus and Providencia might be resistant). No effect is seen on TB, spores and vira. The effect on fungi is variable.
The bactericidal effect is enhanced by alcohol.
pH dependant - optimum is ph 5,5-7,0 but it works in the range pH 5-8. pH-values lower than 5 vil give a destruction of chlorhexidine, whereas pH values above 8 vil cause a precipitation of the chlorhexidinebase.
In the presence of inorganic iones the heavily soluable chlorhexidinesalts wil precipitate, thus reducing the available amount.
It is inactivated by cork.
How does it work:
Toxicity:
Low toxicity, but when used frequently through a longer period of time, a few cases of contact dermatitis and fotosensibilisation have been observed.
Effect on other materials:
It is inactivated by cork.
Preparations for use do not damage metals or plastics.
Use:
Skin/hands: 0,5% or 1% dissolved in alcohol
Instruments: 0,5% dissolved in alcohol
Name: CHLORINE PREPARATIONS
Rapidly acting disinfectants after a period of induction. Organic chlorine compounds have a longer period of induction as do inorganic compounds (e.g. chloramine (氯亞明) T and sodium hypochlorite (n.次氯酸鹽) ).
1 gram chlorine/liter of water = 1 gram active chlorine pr. liter
Effect:
Very efficient with rapid action on bacteria, vira and most fungi.With higher concentration and/or longer time to effect, there is effect on TB, spores and the rest of the fungi.
Maximum effect at pH =7; at pH > 8-9 the effect is strongly reduced.
When pH is falling , the stability of the solution is reduced.
Some organic chlorine preparations may have effect in the range from pH 5-10.
The efficacy is strongly reduced by organic matter - when it reacts with protein chloramines are produced; they are bactericidal, but they work very slowly.
Contact time should be 10-60 minutes.
How does it work:
The effect is caused by the undissociated chlorundersyrling
Toxicity:
Chlorine preparations mixed with acid creates very toxic vapours.
Strong solutions of hypochlorite smell unpleasantly and are toxic - use thiosulfate as antidote.
Strong solutions of hypochlorite are caustic or strongy irritant to skin, eyes and mucous membranes, whereas solutions ready for use not are irritant.
When used through a longer period of time, chlorexema may arise.
Effect on other materials:
Very corrosive, especially to aluminium, but even stainless steel is damaged.
They have a bleaching effect.
Many plastics are resistent to chlorine preparations.
Interactions:
Chlorine preparations mixed with acid creates very toxic vapours.
Use:
Inorganic chlorine preparations:
Solutions for use are unstabile and should be freshly prepared/not more than 48 hours.
Rooms/tools: 200 mg - 10g active chlorine/liter
Organic chlorine preparations:
Hands: 1000-2500 mg active chlorine/liter
Instruments: 5000 mg active chlorine/liter
Name: IODINE PREPARATIONS
Iodine and iodophors. Rapid acting disinfectants.
Iodophors is an aqueous solution where iodine is "made soluble" by means of a detergent. There is an equilibrium (n.平衡;均衡;均勢)between free iodine and complex-bound iodine. As the free iodine is used, the equilibrium is displaced and bound iodine is liberated.
Iodine dissolves poorly in water but is readily soluble in alcohol.
Effect:
It is effective against all kinds of germs. Spores and TB, however, takes higher concentrations. The effect is enhanced when they are dissolved in alcohol.
The efficacy is reduced by organic matter. 5 % serum reduces the effect 4 - 20 times.
Efficient over a wide pH range, but it has maximum effect in an acid or neutral environment. Iodophor solutions retain good bactericidal activity in the prsence of organic matter as long as pH does not go higher than 4.
Iodophors has reduced effect at pH>8.
Iodophores: The solution is brown/yellow and will loose its colour as it is inactivated.
Contact time should be 10-30 minutes.
How does it work:
Iodine preparations reacts with hydroxyl groups and inactivates proteins.
Toxicity:
Iodine: Irritating to tissue. People, who are allergic to iodine might get contact-dermatitis.
When the skin is intact iodine is only slightly absorbed, whereas damaged skin might absorb large amounts.
Iodophors are less irritating. The solutions for use is untoxic and non-irritating - but has limited durability.
Effect on other materials:
Very corrosive to metals ( not stainless steel).
Very staining on plastic and textiles.
Rubber will crumble under long influence from iodine preparations
Interaction:
Iodine preparations should not be used together with quaternary ammonium compounds as it inactivates them.
Iodophors are rapudly inactivated by contact with metals, except from stainless steel. Furthermore they are inactivated by temperatures above 35 °C (sunlight) - this can by seen as the brown colour of the solution will be reduced or disappear by the inactivation.
Use:
Iodine: Skin: 0,5-5% dissolved in 80-90% alcohol
Iodophors: Skin: 1000 mg active iodine/l
Hands: 200-500 mg active iodine/l
Instruments: 500 mg active iodine/l
Name: OXYDIZING AGENTS
E.g. Hydrogen peroxide, Peracids and chlorine dioxide
Concentrated solutions - 30-35% hydrogen peroxide and 40 % peracid - are explosive.
Effect:
Hydrogen peroxide: effect on bacteria, vira and most fungi. At higher concentrations the rest of the fungi and spores are killed.
Peracids: Kills bacteria, fungi, spores and vira. It works more rapidly and with lower concentration than hydrogen peroxide.
Efficient at low temperatures. Effect is reduced by organic matter.
Chlorine dioxide: Very efficient against all germs (fungi takes longer time). It is activated by lowering pH, which gives a rapid action
How does it work:
Gives a lethal oxydation in the microorganisms.
Toxicity:
Concentrated solutions may cause serious cauterizations on skin, eyes and mucous membranes.
Inhalation may irritate the airways and might on sight result in cronical bronchitis.
Chlorine dioxide: Low toxicity. Concentrated solutions gives no skinirritation and only slight eyeirritation.
Effect on other materials:
Peracid is corrosive on metals (especially iron, brass and copper), but is less agressive than chlorine and iodine.
Chlorine dioxide is (almost) non-corrosive.
Use:
H2O2: 3-30 % aqueous solution
Peracid: 0,001-0,3% aqueous soulution
Chlorine dioxide: Instrument disinfection and gas sterilization of germ-free animal chambers
Name: PHENOLICS
Phenol (carbolic acid), cresols and synthetical phenolderivatives have all strong bactericidal effect.
Simple phenolics have a penetrating odor, whereas higher phenolics are odourless. They are heavily degradable.
Effect:
Simple phenolics: Best effect on gram- bacteria. With higher concentration and longer time to work there will be effect on TB.
Multiple phenolics are effective against gram+ (bacteriostatic) as well as gram- bacteria.
Variable effect on fungi. No effect on spores and vira.
Rate of action varies with concentration and type of phenolic compound.
Simple phenolics are effective in the presence of organic matter, whereas multiple phenolics may have a limited activity.
Phenolics are not very temperature- and time dependent.
Contact time should be 10-30 minutes. Phenolic compounds leaves on a residual film, which may be desirable on some surfaces, but unwanted in other connections, eg. in culture systems.
How does it work:
Phenolic compounds function by denaturing and coagulating the protein within the cells. In low concentrations, phenol disrupt the cell wall, allowing leakage of cellular constituents.
Toxicity:
It is easily absorbed through skin and mucous membranes, which gives a toxic action on the kidney and Central Nervous System.
Large amounts of phenolics might be absorbed in rubber and plastic.
Short skin contact with a solution for use will normally give no skin reaction.
Concentrated solution: Short contact will give skin irritation, whereas longer skin contact will give cauterizations.
Effect on other materials:
Low corrosiveness; aluminium might be affected with alkaline pH.
Large amounts og phenols might damage rubber and plastic.
Optical instruments might be damaged
Use:
Instruments: 3-5%
Name: QUATERNARY AMMONIUM COMPOUNDS
Cationic detergents with bactericidal effect.
Effect:
Effective against Gram+ bacteria and most gram- (Pseudomonas and Serratia might be resistent - Pseudomonas might even multiply in solutions for use) When used over a longer period, there can be a selection in favour of gram- bacteria.
There is some effect on fungi, but fungi with a lipoid-layer like Fusarium are difficult to affect. There is no sporocidal and virocidal effect, as well as no effect on TB is observed.
Efficiency is reduced in the presence of organic matter.
Quaternary ammonium compounds is adsorbed to rubber, cotton and other porous matters à concentration is reduced.
It is inactivated by low pH solutions, phospholipids, organic compounds and metal ions, and therefore there is limited effectiveness in soaps, detergents and hard water salts.
The bactericidal effect is enhanced by alcohol.
The best effect is seen in a weakly alkaline environnement.
Contact time should be 10-30 minutes.
How does it work:
They contain alkyl groups that interact with membrane lipids to disrupt the cytoplasmic membrane of bacteria.
Toxicity:
Solutions for use are untoxic.
Concentrated solutions irritates eyes, skin and mucous membranes.
There has been reports of a few cases of allergy.
Lethal dose is estimated to be 1-3 grams in the form of concentrated solution in humans.
Effect on other materials:
Slightly corrosive on aluminium and iron. The corrosive effect on iron may be neutralized by the addition of 0,5% sodiumnitrit.
Rubber may get "greasy" after longer influence.
Use:
Hands: 0,1%
Skin: 0,1-0,2% dissolved in alcohol
Instruments: 1-2%
Surfaces: 0,5%
Solutions <0,5 % should be freshly prepared
_________________________________________________________________________
Our recommendations:
To summ up the above, we will close this subject by giving some recommandations for disinfectants for use in the laboratory - where no special considerations are to be taken regarding microorganisms, materials etc.
For surfaces:
Alcohol - ethanol 70%
Some chlorine preparations
Peracids (Oxydizing agents)
For hands:
Hygienic handwash - ethanol 70%
For instruments:
a. As pretreatment prior to sterilisation:
Chlorine preparations
b. As the only treatment:
Chlorine preparations
Peracids (Oxydizing agents)
--------------------
www.windrug.com/pic/10/12/19/13/010.htm - 網頁紀錄
十一烯酸 undecylenic acid
【历史】 本品为消毒防腐药，是一种含11碳在不饱和脂肪酸，由卡夫特（krafft）于1877年由减压蒸馏蓖麻油制得，1937年正式生产，我国于1958年投产。中国、美国、英国、德国、法国、意大利、瑞士等国药典均有收载。
【其他名称】 undecenoic acid；undecap。
【性状与稳定性】 十一烯酸为淡黄色至黄色液体；色泽受光与空气影响，遇冷则变成乳白色结晶性团块，有特臭，几不溶于水，能与乙醇、氯仿、乙醚、挥发油或脂肪油任意混合。凝固点不低于21℃。
【药物作用】 本品能抑制真菌的繁殖。
【适应症状】 用于治疗头癣、股癣、足癣等皮肤真菌感染及真菌性阴道炎。对脚癣的疗效最好。
【不良反应与注意事项】 局部外用可引起接触性皮炎。本品为外用药不可内服，当浓度过大时对组织有刺激性。
【用法与用量】 外用。局部涂敷其制剂，须连用数周才能治愈。用于黏膜的浓度不宜大于1％，一日2～3次。
【限定剂型】 软膏剂、外用溶液剂。
【可供选用的上市制剂】
脚气灵软膏（复方十一烯酸锌软膏），生产，每10克中含十一烯酸0.5克，十一烯酸锌2克，锌具有收敛作用，这一作用有助于减轻炎症。
十一烯酸药水（内含酒精）。
脚气灵：软膏剂，天津药业公司生产。20％，每支10克，含十一烯酸锌2克，外用，涂敷患部，一日2～3次。置于密闭、干燥处贮存。含十一烯酸、氧化锌、甘油等。
湿气灵药粉：含十一烯酸、水杨酰苯胺、薄荷油、氧化锌、麝香草酚等。
新脚气灵：软膏剂，沈阳市兴齐制药厂生产。成分十一烯酸、十一烯酸锌、皮质激素，每支10克，外用，一日2～3次，除用于皮肤癣症外，还可以用于过敏皮炎和皮肤瘙痒等。
复方十一烯酸锌软膏：软膏剂，广州何济公制药厂生产。20％，每支10克，含十一烯酸锌2克，外用，用于头癣、足癣，洗净患部后涂敷，一日2～3次。密闭贮存。
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www.lamasbeauty.com/glossary/print_P.html - 網頁紀錄
Pityriasis Alba: Seborrheic dermatitis.
Pityriasis Capitis: Dandruff.
Pityrosporum: Yeast that is a common inhabitant of the skin, usually starting at puberty. Not the yeast that causes vaginitis in women.
Pityrosporum Folliculitis: An acne-like rash composed of minute papules and pustules but no comedones (blackheads / whiteheads). It occurs most frequently on the forehead and sides of the face.
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http://web.uct.ac.za/depts/mmi/jmoodie/d01html.html#D01B
D01B ANTIFUNGALS FOR SYSTEMIC USE
Griseofulvin, certain azoles, and terbinafine are used systemically for serious or intractable dermatomycoses. Use should be restricted to the treatment of chronic infections not responding to topical measures.
Griseofulvin, an antifungal antibiotic, exerts an inhibitory action against common dermatophytes. It is inactive against yeasts and yeast-like fungi, including candida and pityrosporum species. It has no effect on fungi producing deep mycoses or on bacteria.
Terbinafine, an allylamine, is fungicidal against dermatophytes and some yeasts, but only fungistatic against C.albicans. Oral terbinafine is not effective in pityriasis versicolor.
Ketoconazole, fluconazole and itraconazole are effective for both yeast and dermatophyte infections. For full profiles, see section J02.
Intermittent therapy with itraconazole may be used for managing onychomycoses. As this agent is concentrated in the nail plate, it has been found that continuous therapy is not necessary. Ideally chemical or physical removal of the infected dystrophic nail plate should be used in conjunction with oral medication: itraconazole 200 mg/day, 1 week/month for 4 months.
Griseofulvin
(WHO essential agent)
Indications: Dermatophyte infections of the skin and appendages. Systemic administration is used for hair infections and failed topical management of all tinea infections.
Pharmacokinetics: Irregular absorption occurs over a prolonged period of time. It is deposited in keratinocytes and concentrated in the stratum corneum, nails and hair.
Absorbed drug is metabolised in the liver and excreted in urine. A large amount of an oral dose is excreted unchanged in faeces.
Precautions:
Contraindications: Liver failure; history of hypersensitivity to griseofulvin. Use with caution in systemic lupus erythematosus.
Drug interactions:
Alcohol: The effect of alcohol may be potentiated.
Antiepileptic agents: Effects of griseofulvin may be diminished.
Oral contraceptives: May result in contraceptive failure or breakthrough bleeding.
Warfarin: Anticoagulant effect may be reduced.
Pregnancy: Crosses the placenta; embryotoxic and teratogenic in animals. Avoid.
Lactation: Not known if excreted in breast milk; problems not documented.
Porphyria: Avoid
Geriatrics: Use with caution.
Paediatrics: Use is well established.
Adverse effects: Frequent - mild and transient headaches, skin rashes, GI disturbances, altered taste sensation and dry mouth.
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http://www.sim.fi/eng/products/System4/system4.html (Commercial page)
System 4
Very effective treatment for various scalp problems.
Countless users of System 4 have already found relief for conditions such as: dandruff, fungi, bacteria, yeast fungus, itching, psoriasis, atopic dermatitis, irritated skin, excessive secretion of sebaceous glands, hair loss or poor scalp microcirculation.
System 4 provides therapeutic synergy between shampoos and treatments. Not only do all the products provide individual benefits, but they also improve the effect of other System 4 products.
System 4 products include only dermatologically tested, safe raw materials.
The unique effect of System 4 is achieved using the following ingredients:
Climbazole is highly effective against one of the main causes of dandruff, the malassezia furfur fungus.
Piroctone olamine is effective against the pityrosporum fungus, another fungus causing dandruff.
Salicylic acid is an effective scalp and
keratosis exfoliater.
Undecylenic acid prevents excessive sebum secretion and calms irritated skin.
Rosemary stimulates hair growth.
----------------
http://www.nutramed.com/skin/skinfungal.htm
ANTIFUNGAL
Imidazoles are active against dermatophyte and candida and pityrosporum infections. They also inhibits growth of some gram-positive bacteria.
Canesten, clozole, lotremin, myco-hermal, 1% clotrimazole (cr or lotion)
Daktarin, 2% miconazole cr
Dermazole, pervaryl, 1% econazole nitrate cr
Exelderm, 1 % sulconazole nitrate cr
Mycospor, 1% bifonazole cr
Travogen, 1% isoconazole cr
Trosyd, 1% tioconazole cr
10.2 Allylamine are active against dermatophyte but less effective against candia and pityrosporum infections when compared with azole derivatives.
Exoderil : 1% Naftifine HCl cr
Lamisil : 1% Terbinafine cr
10.3 Polyenes are active against candida sp but not dermatophytes.
Fungizone : 3% amphotericin B cr
Mycostatin, : 100,000 u/gm Nystatin cr
Nadostine
10.4 Miscellaneous compounds including older products that are generally less active and more irritant and newer agents that do not fall into a particular class of drugs listed above.
- Tolnaftate active againsts dermatophytes and pityriasis versicolor but not candida & bacteria.
Aftate; Scholl; : containing 1% (cr/solution/powd spray)
Tinaderm
- Ciclopiroxolamine spectrum similar to imidazole.
Batrafen : containing 1% cr
- Undecylenic acid more irrtant, ususally as an ingredient of foot powders for prophylaxis or treatment of tinea pedis.
Dagra foot powder : Zn undecylenate (salicylic acid, boric acid, hexachlorophene)
Other including : Detrisol oint, egomycol solution, mycoderm cr/powd, mycota cr/powd/spray, tineafax oint/powd, benzoderm soap
- Haloprogin is active against dermatophyte, tinea versicolor and in vitro also against staphylococci, streptococci, and candida albicans.
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http://www.mesinc.com/education/monographs2/cme023/content/11.html
ITRACONAZOLE
Itraconazole is a synthetic triazole antifungal agent that inhibits the synthesis of ergosterol, an integral constituent of the cytoplasmic membrane of fungal cells. Specifically, it inhibits the cytochrome P450 (CYP 450)-dependent 14a-demethylase and leads to an accumulation of methylated sterols such as lanosterol and, thus, a defective cell membrane with altered permeability and function.40
Spectrum of Activity
Itraconazole has a broad spectrum of in vitro activity and a high affinity for keratinized tissues, which results in high concentrations of the drug in the nail plate.11 The therapeutic activity of itraconazole has been demonstrated against infections caused by dermatophytes, Candida sp, Pityrosporum infections, and nondermatophyte molds, such as Aspergillus sp, Fusarium sp, Alternia sp, and Scopulariopsis brevicaulis.16 Itraconazole may be considered the drug of first choice in mixed infections because of this wide spectrum of activity.
Clinical Efficacy
Numerous studies demonstrating the efficacy of itraconazole for the treatment of onychomycosis have been conducted in the US and Europe in doses ranging from 100 to 600 mg/day.41,42 Pulse therapy, consisting of two pulses of 200 mg itraconazole twice daily for 1 week separated by 3 weeks off treatment is the recommended treatment regimen for fingernail onychomycosis. The FDA-approved treatment regimen for toenail infections is 200 mg once daily for 12 weeks; however, clinical research has shown that three pulses of treatment (200 mg twice daily for 1 week per month for 3 consecutive months) are as effective as continuous therapy for the treatment of toenail onychomycosis, and this has become the standard of care.30,31
Pooled data (14 studies; 1389 patients)41 indicate that three pulses of itraconazole for the treatment of dermatophyte toenail onychomycosis result in clinical cure, clinical response, mycologic cure rates, and relapse rates of 58%, 82%, 77%, and 10%, respectively, 12 months after the start of therapy. Similarly, two pulses of itraconazole for the treatment of fingernail onychomycosis result in clinical cure, clinical response, mycologic cure rates, and relapse rates of 78%, 89%, 77%, and 4.9%, respectively, 9 months after the start of therapy
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www.aafp.org/afp/20031115/1963.html - 網頁紀錄
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http://www.interpharmaplus.com/product.php?p=179
Product Information
Nizoral (Ketoconazole) cream Box with tube with 40 g
Active Ingredient:
Ketoconazol 2g
Directions:
NIZORAL Cream is indicated
in the treatment of the infections
in the skin:
membranes due to Trichophyton mentagrophytes,
Microsporum canis and Epidermophyton floccosum, like in the
treatment of the nea candidosis , vulvitis and
pitiriasis.
indicated in the treatment of the
seborreica dermatitis when the presence of Pityrosporum is
demonstrated makes oval.
Warning:
Cream is not for oftálmic use. In order to prevent the effect it
bounces after suspending a treatment prolonged with corticosteroides
topical, is recommendable to continue with the application of a
moderate topical corticoesteroide in the mornings and to apply to
NIZORAL * cream in, afternoon subsequent and gradually retiring the
therapy with steroids in a period of 2-3 weeks.
In Stock
Price: $19.99 Shipping: Click to see our rates
Handling: $0.00
---------
http://www.ecureme.com/emyhealth/Pediatrics/Cradle_Cap.asp
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http://archderm.ama-assn.org/cgi/content/abstract/112/3/350
Clinical evaluation of clotrimazole. A broad-spectrum antifungal agent
P. H. Spiekermann and M. D. Young
The efficacy and safety of the broad-spectrum, topically applied antifungal agent clotrimazole were evaluated in two double-blind, multicentric trials. Ten investigators reported on a total of 1,361 cases in which a 1% solution or a 1% cream formulation was compared with its respective vehicle. Clotrimazole was therapeutically effective, as confirmed by mycological cure (negative microscopy and culture) and clinical improvement, in tinea pedis, tinea cruris, tinea corporis, pityriasis versicolor, and cutaneous candidasis. Furthermore, species identification established the efficacy of clotrimazole against Trichophyton rubrum, T mentagrophytes, Epidermophyton floccosum, Microsporum canis, Malassezia furfur (Pityrosporum orbiculare), and Candida albicans. Safety was demonstrated by the low incidence of possibly drug-related adverse experiences, namely, 19 (2.7%) of 699 patients who were treated with clotrimazole, of whom four (0.6%) discontinued treatment.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
----------------
The PASCO antifungal susceptibility test system, developed in collaboration with a commercial company, is a broth microdilution assay which is faster and easier to use than the reference broth microdilution test performed according to the National Committee for Clinical Laboratory Standards (NCCLS) document M27-A guidelines. Advantages of the PASCO system include the system's inclusion of quality-controlled, premade antifungal panels containing 10, twofold serial dilutions of drugs and a one-step inoculation system whereby all wells are simultaneously inoculated in a single step. For the prototype panel, we chose eight antifungal agents for in vitro testing (amphotericin B, flucytosine, fluconazole, ketoconazole, itraconazole, clotrimazole, miconazole, and terconazole) and compared the results with those of the NCCLS method for testing 74 yeast isolates (14 Candida albicans, 10 Candida glabrata, 10 Candida tropicalis, 10 Candida krusei, 10 Candida dubliniensis, 10 Candida parapsilosis, and 10 Cryptococcus neoformans isolates). The overall agreements between the methods were 91% for fluconazole, 89% for amphotericin B and ketoconazole, 85% for itraconazole, 80% for flucytosine, 77% for terconazole, 66% for miconazole, and 53% for clotrimazole. In contrast to the M27-A reference method, the PASCO method classified as resistant seven itraconazole-susceptible isolates (9%), two fluconazole-susceptible isolates (3%), and three flucytosine-susceptible isolates (4%), representing 12 major errors. In addition, it classified two fluconazole-resistant isolates (3%) and one flucytosine-resistant isolate (1%) as susceptible, representing three very major errors. Overall, the agreement between the methods was greater than or equal to 80% for four of the seven species tested (C. dubliniensis, C. glabrata, C. krusei, and C. neoformans). The lowest agreement between methods was observed for miconazole and clotrimazole and for C. krusei isolates tested against terconazole. When the data for miconazole and clotrimazole were removed from the analysis, agreement was 80% for all seven species tested. Therefore, the PASCO method is a suitable alternative procedure for the testing of the antifungal susceptibilities of the medically important Candida spp. and C. neoformans against a range of antifungal agents with the exceptions only of miconazole and clotrimazole and of terconazole against C. krusei isolates.
--------------
http://www.peacehealth.org/kbase/multum/d01236t1.htm
clotrimazole topical
Pronunciation: kloe TRIM a zole
Brand: Desenex AF Prescription Strength, Fungoid Solution, Lotrimin, Lotrimin AF, Lotrimin Jock Itch Powder, Mycelex, Mycelex OTC
What is the most important information I should know about clotrimazole topical?
Use this medication for the full amount of time prescribed by your doctor or as recommended in the package even if you begin to feel better. Your symptoms may improve before the infection is completely healed.
Do not use bandages or dressings that do not allow air to circulate to the affected area (occlusive dressings) unless otherwise directed by your doctor. Wear loose-fitting clothing (preferably cotton).
Avoid getting this medication in your eyes, nose, or mouth.
What is clotrimazole topical?
Clotrimazole topical is an antifungal medication. Clotrimazole topical prevents fungus from growing on your skin.
Clotrimazole topical is used to treat skin infections such as athlete's foot, jock itch, ringworm, and yeast infections.
Clotrimazole topical may also be used for purposes other than those listed in this medication guide.
Who should not use clotrimazole topical?
Do not use clotrimazole topical if you have had an allergic reaction to it in the past.
Clotrimazole topical is in the FDA pregnancy category B. This means that it is unlikely to harm an unborn baby. Do not use clotrimazole topical without first talking to your doctor if you are pregnant.
It is not known whether clotrimazole passes into breast milk. Do not use clotrimazole topical without first talking to your doctor if you are breast-feeding a baby.
How should I use clotrimazole topical?
Use clotrimazole topical exactly as directed by your doctor or follow the directions that accompany the package. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
Wash your hands before and after using this medication, unless you are using it to treat a hand infection.
Clean and dry the affected area. Apply a small amount of the cream (usually twice daily) for 2 to 4 weeks.
Do not take this medication by mouth.
If the infection does not clear up in 4 weeks, or if it appears to get worse, see your doctor.
Use this medication for the full amount of time prescribed by your doctor or as recommended in the package even if you begin to feel better. Your symptoms may improve before the infection is completely healed.
Do not use bandages or dressings that do not allow air circulation over the affected area (occlusive dressings) unless otherwise directed by your doctor. A light cotton-gauze dressing may be used to protect clothing.
Avoid getting this medication in your eyes, nose, or mouth.
Store clotrimazole topical at room temperature away from moisture and heat.
What happens if I miss a dose?
Apply the missed dose as soon as you remember. However, if it is almost time for your next regularly scheduled dose, skip the dose you missed and apply only the regular amount of clotrimazole topical. Do not use a double dose unless otherwise directed by your doctor.
What happens if I overdose?
An overdose of clotrimazole topical is unlikely to occur. If you do suspect that a much larger than normal dose has been used, or that clotrimazole topical has been ingested, contact an emergency room or a poison control center.
What should I avoid while using clotrimazole topical?
Avoid wearing tight-fitting, synthetic clothing that doesn't allow air circulation. Wear clothing made of loose cotton and other natural fibers until the infection is healed.
What are the possible side effects of clotrimazole topical?
Serious side effects of clotrimazole topical use are not expected. Stop using clotrimazole topical and see your doctor if you experience unusual or severe blistering, itching, redness, peeling, dryness, swelling, or irritation of the skin.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect clotrimazole topical?
Avoid using other topicals at the same time unless your doctor approves. Other skin medications may affect the absorption or effectiveness of clotrimazole topical.
Drugs other than those listed here may also interact with clotrimazole topical. Talk to your doctor and pharmacist before taking or using any other prescription or over-the-counter medicines.
Where can I get more information?
Your pharmacist has additional information about clotrimazole topical written for health professionals that you may read.
What does my medication look like?
Clotrimazole topical is available under the brand name Lotrimin for prescription products and under the brand name Lotrimin AF for over-the-counter products. Other brand or generic formulations may also be available. Clotrimazole topical is available as a cream, a solution, and a lotion. Ask your pharmacist any questions you have about this medication, especially if it is new to you.
-----------
http://www.inhousedrugstore-europe.com/infections/daktarin.html (Commercial)
Daktarin Oral Gel - an overview
Uses:
DAKTARIN oral gel is indicated for the treatment of clinically significant oral and gastrointestinal candidiasis "Oral Trush". Miconazole possesses an antifungal activity against the common dermatophytes and yeasts as well as an antibacterial activity against certain gram-positive bacilli and cocci. Its activity is based on the inhibition of the ergosterol biosynthesis in fungi and the change in the composition of the lipid components in the membrane, resulting in fungal cell necrosis.
Dosage and Administration
Infants :
For infants less than one year old, one quarter (? of a measuring spoon* of gel four times daily, or 20 mg/kg/day is recommended.
Children and Adults :
Half (? a measuring spoon* of gel four times daily.
* A measuring spoon (5 mL) is provided with the gel. One spoonful contains approximately 124 mg of miconazole.
All spoonful dose volumes should be administered with this spoon .
DAKTARIN oral gel should be placed on the tongue and kept in mouth for as long as possible before swallowing.
When treating infants and younger children it is recommended that the measured dose of gel be given in several portions in the front of the mouth.
Avoid dosing to the back of the throat to prevent obstruction.
With oral thrush in elderly patients where a contributing cause is the dental prosthesis, it is recommended that DAKTARIN oral gel be applied directly to the dentures in the evening and left on overnight.
The treatment should be continued for at least one week after the symptoms have disappeared and generally until all clinical and mycological laboratory tests no longer indicate that active fungal infection is present.
Contraindications
DAKTARIN oral gel is contraindicated in patients with known hypersensitivity to any of its components and in patients with liver dysfunction.
-----------------
http://www.anti-aging-drugs.com/?chapter=nizoral
Why is this drug prescribed?
Nizoral, a broad-spectrum antifungal drug available in tablet form, may be given to treat several fungal infections within the body, including oral thrush and candidiasis.
It may also be given to treat severe, hard-to-treat fungal skin infections that have not cleared up after treatment with creams or ointments, or the oral drug griseofulvin (Fulvicin, Grisactin).
Most important fact about this drug
In some people, Nizoral may cause serious or even fatal damage to the liver. Before starting to take Nizoral, and at frequent intervals while you are taking it, you should have blood tests to evaluate your liver function. Tell your doctor immediately if you experience any signs or symptoms that could mean liver damage: these include unusual fatigue, loss of appetite, nausea or vomiting, jaundice, dark urine, or pale stools.
How should you take this medication?
Take Nizoral exactly as prescribed.
You should keep taking the drug until tests show that your fungal infection has subsided. If you stop too soon, the infection might return.
You may want to take Nizoral Tablets with meals to avoid stomach upset.
Avoid alcohol and do not take with antacids. If antacids are necessary, you should wait 2 to 3 hours before taking them.
--If you miss a dose...
Take the forgotten dose as soon as you remember. This will help to keep the proper amount of medicine in the body. However, if it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take double doses.
--Storage instructions...
Nizoral should be stored at room temperature.
What side effects may occur?
Side effects from Nizoral cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Nizoral.
More common side effects may include:
Nausea, vomiting
Less common side effects may include:
Abdominal pain, itching
Rare side effects may include:
Breast swelling (in men), depression, diarrhea, dizziness, drowsiness, fever and chills, headache, hives, impotence, light-sensitivity, rash
--------------------------
http://www.medsafe.govt.nz/Profs/datasheet/n/Nizoralcr.htm
NIZORAL*
ketoconazole 2% Cream
Presentation
NIZORAL Cream contains the synthetic broad-spectrum anti-fungal agent, ketoconazole. Each gram contains 20mg ketoconazole. The cream formulation consists of propylene glycol, stearyl alcohol, cetyl alcohol, sorbitan stearate, polysorbate, isopropyl myristate, sodium sulphite and purified water
Uses
Actions
Ketoconazole, a synthetic imidazole dioxolane derivative, has a potent antimycotic activity against dermatophytes such as Trichophyton sp., Epidermophyton floccosum and Microsporum sp. and against yeasts. In particular the effect on Pityrosporum sp. is very pronounced.
Usually ketoconazole cream acts very rapidly on pruritus which is commonly seen in dermatophyte and yeast infections as well as skin conditions associated with the presence of Pityrosporum sp. This symptomatic improvement is observed before the first signs of healing are observed.
Pharmacokinetics
NIZORAL Cream does not produce detectable blood levels after topical application.
Indications
NIZORAL Cream is indicated for topical application in the treatment of dermatophyte infections of the skin; tinea corporis, tinea cruris, tinea manus and tinea pedis due to Trichophyton rubrum, Trichophyton mentagrophytes, Microsporum canis and Epidermophyton floccosum, as well as in the treatment of cutaneous candidiasis and tinea (pityriasis) versicolor. NIZORAL Cream is also indicated for the treatment of seborrhoeic dermatitis, a skin condition associated with the presence of Pityrosporum ovale.
Overdosage
Excessive topical application may lead to erythema, oedema and a burning sensation, which will disappear upon discontinuation of the treatment. No special measures have to be taken in case of accidental ingestion.
-------------
http://www.ctclconsult.com/pdrdruginfo/html/49950620.htm
PDR® entry for
Nizoral 2% Shampoo (McNeil Consumer)
DESCRIPTION
NIZORAL® (ketoconazole) 2% Shampoo is a red-orange liquid for topical application, containing the broad-spectrum synthetic antifungal agent ketoconazole in a concentration of 2% in an aqueous suspension. It also contains: coconut fatty acid diethanolamide, disodium monolauryl ether sulfosuccinate, F.D. & C. Red No. 40, hydrochloric acid, imidurea, laurdimonium hydrolyzed animal collagen, macrogol 120 methyl-glucose dioleate, perfume bouquet, sodium chloride, sodium hydroxide, sodium lauryl ether sulfate, and purified water.
Ketoconazole is cis-1-acetyl-4-[4-[[2-(2,4-di-chlorophenyl)-2-(1H-imidazol-1-ylmethyl)-1,3-dioxolan-4-yl]methoxy]phenyl]piperazine.
Microbiology: NIZORAL® (ketoconazole) is a broad-spectrum synthetic antifungal agent which inhibits the growth of the following common dermatophytes and yeasts by altering the permeability of the cell membrane: dermatophytes: Trichophyton rubrum, T. mentagrophytes, T. tonsurans, Microsporum canis, M. audouini, M. gypseum and Epidermophyton floccosum; yeasts: Candida albicans, C. tropicalis, Pityrosporum ovale (Malassezia ovale) and Pityrosporum orbiculare (M. furfur). Development of resistance by these microorganisms to ketoconazole has not been reported.
-----
http://www.hkmj.org.hk/skin/commerci.htm
3. SHAMPOO
Nizoral shampoo: ketoconazole 2%
Polytar liquid: tar 0.3%, cade oil 0.3%, coal tar 0.1%, arachis oil extr of crude coal tar 0.3%, oleyl alcohol 1%
12. ANTIFUNGAL
12.1. Imidazoles are active against dermatophyte, candida and pityrosporum infections. They also inhibit the growth of some gram-positive bacteria.
Canesten: clotrimazole 1%
Clozole: clotrimazole 1%
Daktarin: miconazole 2%
Dermazole: econazole 15
Exelderm: sulconazole nitrate 1%
Lotremin: clotrimazole 1%
Myco-hermal: clotrimazole 1%
Mycospor: bifonazole 1%
Pervaryl: econazole 1%
Travogen: isoconazole 1%
Trosyd: tioconazole 1%
12.2. Allylamine are active against dermatophyte but less effective against candida and pityrosporum infection as compared to the azole derivatives.
Exoderil: naftifine HCl 1%
Lamisil: terbinafine 1%
12.3. Polyenes are active against candida sp but not dermatophytes.
Fungizone: amphotericin B 3%
Mycostatin: nystatin 100,000 iu per gm
Nadostine: nystatin 100,000 iu per gm
12.4. Miscellaneous compounds including older products that are generally less active and more irritant than newer agents that do not fall into a particular class of drugs listed above.
- Tolnaftate is active against dermatophytes and pityrosporum ovale but not candida and bacteria.
Aftate/Scholl/Tinaderm contain 1% tolnaftate in the form of cream, solution, powder and powder spray that can be bought over the counter.
- Ciclopirox-olamine has a spectrum similar to imidazoles.
Batrafen: ciclopirox-olamine 1%
- Undecyclenic acid/Zn undecylenate are more irritant, usually as an ingredient of foot powders for prophylaxis or treatment of tinea pedis.
Dagra foot powder: zn undecylenate (salicylis acid, boric acid, hexachlorphene)
Other including: detrisol oint, egomycol solution, mycoderm cr/powd, mycota cr/powd/spray, tineafax oint/powd, benzoderm soap
- Haloprogin is active against dermatophyte, pityrosporum and in vitro also against staphylococci, streptococci, and candida albicans.
Polik: haloprogin 1% sol
- Tolciclate has a spectrum similar to imidazoles.
Tolmicen: tolciclate 1% cr/lotion, 0.5% powd
---------------
http://web.uct.ac.za/depts/mmi/jmoodie/d11html.html
---D11AC Medicated shampoos ---
Imidazoles, e.g. ketoconazole and econazole, are useful for managing pityrosporum-related problems, e.g. tinea versicolor and seborrhoeic dermatitis. See section D01 (Nizshampoo? Pevaryl?foaming solution; also Selsun?.
----------------
http://www.jcaai.org/param/Eczema/Infect.htm
Infectious Agents
Skin infections, particularly with Staphylococcus aureus, can be a recurrent problem in atopic dermatitis requiring specific treatment. (37) Anti-staphylococcal antibiotics may be very helpful in the treatment of patients who are heavily colonized with S. aureus. (38) Erythromycin and the newer macrolide antibiotics (azithromycin & clarithromycin) are usually beneficial and safe for patients who are not colonized with a resistant S. aureus strain. In patients with macrolide-resistant S. aureus, a penicillinase-resistant penicillin (dicloxacillin, oxacillin, or cloxacillin) may be preferred. First generation cephalosporins also offer effective coverage for both staphylococci and streptococci. All macrolide antibiotics, if administered with either terfenadine or astemizole, have the potential to alter the electrocardiogram and provoke cardiac arrhythmias (torsades des pointes) in patients. Topical mupirocin may offer some utility in the treatment of impetiginized lesions (39); however, in patients with extensive superinfection, a course of systemic antibiotics is preferred.
Herpes simplex can occasionally provoke recurrent dermatitis in patients with atopy, and may be misdiagnosed as a staphylococcal infection. When vesiculation is present or when infected skin lesions fail to respond to oral antibiotics, the physician should suspect the possibility of herpes simplex infection. This can be diagnosed by a Giemsa-stained Tzanck smear of cells scraped from the vesicle base or by viral culture. Herpes simplex infections may be localized or become disseminated (Kaposi's varicelliform eruption) in patients with atopic dermatitis. Antiviral treatment for cutaneous herpes simplex infections is of critical importance in the patient with widespread atopic dermatitis since life threatening dissemination has been reported. (40,41) Acyclovir, 400 mg three times daily for ten days or 200 mg four times daily for ten days by oral administration, is useful in adults with herpes simplex confined to the skin. The dosage should be adjusted according to the weight in children.
Dermatophyte infections can complicate atopic dermatitis and may contribute to exacerbation of disease activity. Elevated serum IgE levels to both trichophytic antigens and to Pityrosporum ovale, a lipophilic yeast, have been reported. (42-44) A pathogenic contribution from dermatophyte (45) and P. ovale (45) infections is suggested by improvement of atopic dermatitis in infected patients following treatment with antifungal agents. Infestation with scabies should also be considered in the differential diagnosis of flaring atopic dermatitis, and can be diagnosed with skin scrapings examined under the microscope.
--------------------------------
http://education.vetmed.vt.edu/Curriculum/VM8784/AbxSuscept.htm
TETRACYCLINES
TETRACYCLINES CHLORTETRACYCLINE, OXYTETRACYCLINE, TETRACYCLINE, DOXYCYCLINE, MINOCYCLINE
Differences between the tetracyclines is a matter of solubility (hence pharmacokinetics, tissue penetration, etc.) rather than susceptibility.
Good Gram (+) aerobes: Bacillus sp., Corynebacterium sp., E. rhusiopathiae, L. monocytogenes, streptococci. Gram (-) bacteria: Actinobacillus sp., Bordetella sp. ,Brucella sp., F. tularensis, Haemophilus sp., P. multocida, Yersinia sp., Campylobacter fetus, Borrelia sp., Leptospira sp. Anaerobes: Actinomyces sp., Fusobacterium sp. also: Mycoplasma sp., Chlamydia sp. (including C. psittaci), Rickettsia sp., (inluding C. burnetii, Ehrlichia sp., and protozoa (Theileria, Eperythrozoon, and Anaplasma).
Variable acquired resistance in staphylococci, enterococci, Enterobacteriaceae. Anaerobes such as Bacteroides sp., and Clostridium sp., some Mycoplasma sp. (M. bovis, M. hyopneumoniae are resistant)
Resistant Mycobacterium sp., P. vulgaris, P. aeruginosa, Serratia sp.
ANTIFUNGAL DRUGS
TOPICAL ANTIFUNGAL DRUGS NATAMYCIN, NYSTATIN, CLOTRIMAZOLE, MICONAZOLE
NATAMYCIN
Good wide range of filamentous and dimorphic fungi, yeasts. Including Taenea, Candidia, Fusarium, Aspergillus
NYSTATIN
Good Candida, Pityrosporum, Cryptococcus, dermatophytes, some filamentous fungi and some dimorphic fungi. Prototheca
Resistance several Candida sp. other than C. albicans.
AZOLE ANTIBIOTICS CLOTRIMAZOLE, MICONAZOLE
Good wide range of filamentous fungi, including Aspergillus and dermatophytes, yeasts and dimorphic fungi. Malassezia
SYSTEMIC ANTIFUNGAL DRUGS GRISEOFULVIN, AMPHOTERICIN B, FLUCYTOSINE, AZOLE COMPOUNDS
GRISEOFULVIN
Good all dermatophytes
Resistance all other hyphal fungi, yeasts, dimorphic fungi and bacteria
AMPHOTERICIN B
Good in decreasing order of susceptibility: Blastomyces dermatitidis, Histoplasma capsulatum, Cryptococcus neoformans, Candida spp., Sporothrix schenckii, Coccidioides immitis, Aspergillus. many yeasts are also susceptible as is Prototheca.
Resistance some resistant Candida, C. immitis, Mucor, Aspergillus
FLUCYTOSINE
Good C. neoformans, Candida sp., Torulopsis, Cladosporium a few Aspergillus.
Resistance Dermatophytes, filamentous fungi, and dimorphic fungi. Most yeast isolates from bovine mastitis are resistant.
AZOLE ANTIFUNGAL DRUGS KETOCONAZOLE, ITRACONAZOLE, FLUCONAZOLE
KETOCONAZOLE
Good wide range of filamentous fungi (including dermatophytes), yeasts, dimorphic fungi. C. albicans, Malessezia canis, some Aspergillus.
Resistance some acquired resistance reported, some Aspergillus are resistant. Prototheca are resistant in vitro but respond in vivo. C. tropicalis is resistant.
ITRACONAZOLE
Good in addition to organisms susceptible to ketoconazole: dimorphic fungi, Cryptococcus, Sporothrix, Alternaria, most Aspergillus, C. tropicalis
Variable Candida sp., dermatophytes.
FLUCONIZOLE
Good probably similar to ketoconazole. Still being evaluated.
IODIDES
Iodides have been used for years to treat mycotic infections. Efficacy has never clearly been documented. Often included with other antifungal therapies.
-----------------
http://www.jac.oupjournals.org/cgi/content/full/43/4/579
Fungi and media
All fungi were from the SmithKline Beecham culture collection and were maintained on slopes of Sabouraud's dextrose agar (SDA, Lab M, Bury, UK) and grown in Sabouraud's liquid medium (SDB, Lab M) or synthetic Yeast Nitrogen Base (YNB, Difco, West Molesey, UK) unless stated otherwise. Pityrosporum (Malasezzia) ovale and Pityrosporum orbiculare were cultivated on a medium containing glycerol monostearate, olive oil and Tween 80.6 To facilitate incorporation studies, Trichophyton mentagrophytes was also grown in the synthetic glucose- glutamic acid- salts medium (GGS) of Kole & Bose,7 solidified, where necessary, with 2% agar. Candida albicans,Cryptococcus neoformansand Aspergillus niger were incubated at 37°C and other species at 30°C.
-----------------
http://dermnetnz.org/fungal/pityrosporum-folliculitis.html Picture for pityrosporum
-----------------
http://www.emedicine.com/derm/topic338.htm
Background: Pityrosporum folliculitis (PF) is a common condition in young or middle-aged adults that involves follicular papulopustules on the upper trunk. Weary et al first described PF in 1969, and Potter et al identified PR as a separate clinical and histologic diagnosis in 1973.
The pathogenic agents in PF are yeasts from the genus Pityrosporum?em>Pityrosporum orbiculare and Pityrosporum ovalehich are collectively known as Malassezia furfur. Lesions are chronic, erythematous, pruritic papules and pustules, which occur in a follicular pattern. These lesions usually are present on the back and chest and, occasionally, on the neck, shoulder, upper arm, and face.
Malassez first described P ovale yeasts in 1874 from scales in seborrheic dermatitis. He coined the phrases "bottle bacillus of Unna" to describe the small oval cells in the scale and "spore of Malassez" to name the bud that is observed in association with the yeast.
Because of controversy and confusion of the grouping of various lipophilic yeasts and fungi of the skin, the 2 yeast species, collectively with fungal forms, are classified as M furfur. This grouping has simplified the classification to one name, which applies regardless of the morphology of the organism.
The diagnosis of PF is based on clinical suspicion and the classic presentation of a follicular pattern of papulopustules on the trunk, with either demonstrable M furfur yeast forms or an improvement in the lesions with empiric antiyeast therapy.
Pathophysiology:
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