Fungal Infections may be classified as superficial, affecting only the skin, hair, nail, or mucous membranes, or systemic, affecting the body as a whole; systemic infections tend to occur more frequently in immunocompromised individuals such as those with AIDS.
Drugs used in fungal infections at health center level:
Polyene antifungals - The polyene antifungals include amphotericin (not described here) and Nystatin; neither drug is absorbed when given by mouth. They are used for oral, oropharyngeal, and perioral infections by local application in the mouth.
Nystatin is used principally for candida albicans infections of the skin and mucous membranes, including esophageal and intestinal candidiasis.
Other Antifungals. Griseofulvin is effective for widespread or intractable dermatophyte infections but has been superseded by newer antifungals, particularly for nail infections. It is usually well tolerated and is licensed for use in children. Duration of therapy is dependent on the site of the infection and may be required for a number of months.
Griseofulvin
Tablet, 125mg, 250mg, 500mg
Suspension, 125mg/5ml
Indications: - dermatophyte infections of the skin, scalp, hair and nail where topical therapy has failed or is inappropriate.
Cautions: - rarely aggravation or precipitation of systemic lupus erythematosus; breast-feeding; griseofulvin may impaired the ability to drive or operate machinery, see also drug interaction.
Drug interactions: - phenobarbitone, coumarin anticoagulants and oral contraceptives, aspirin.
Contraindications: - patients with porphyria and liver failure, lupus erythematosus and related conditions, pregnancy (avoid pregnancy during and for 1 month after treatment, men should not father children with in 6 months of treatment)
Side effects: - side effects are usually mild and transient and consist of headache, skin rashes, dryness of the mouth an altered sensation of taste, and gastro-intestinal disturbances; angioedema, erythemamultiforme, toxic epidermal necrolysis, proteinuria, leucopoenia and other blood dyscrasias, candidacies, paraesthesia, photosensitization, and severe headache have been reported occasionally. Depression, confusion, dizziness, insomnia, and fatigue. Griseofulvin may precipitate or aggravate systemic lupus erythematosus.
Dose and Administration
Adult, by mouth, 500mg daily, in divided doses or as a single dose, in severe infection dose may be doubled reducing when response occurs; CHILD, 10mg/kg daily in divided doses or as a single dose.
Storage: - at room temperature, in a tight container.
Nystatin
Tablet, 500,000IU
Indications: - prophylaxis and treatment of candidasis of skin and mucous membranes.
Side effects: - nausea, vomiting, and diarrhea; Steven Johnson syndrome, irritation.
Dose and Administration
Adult, By mouth, intestinal candidiasis 500, 000 unit every 6 hours, doubled in severe infections; CHILD 100,000 units 4 times daily prophylaxis, 1 million units once daily, NEONATE 100,000 units once daily.
Storage: - at room temperature in a tight light resistant container.
