Information for pharmacists

 

Fungal Infections

Fungal infections are very common ailments and, albeit unpleasant, they are mostly harmless. Predominantly caused by dermatophytes and yeasts and very rarely by moulds, fungal infections can occur anywhere.

The most frequently affected parts of the body are the:

  • vagina (vulvo-vaginal candidiasis)
  • feet (tinea pedis)
  • torso (tinea corporis)
  • groin (tinea cruris)

Fungi grow and thrive in warm, moist conditions such as between the toes and in skin folds. These infections of the skin are contagious and usually only affect the epidermal layer.

The majority of fungal infections are caused by two fungi:

Common dermatophyte infections are athlete's foot (tinea pedis), fungal groin infection (tinea cruris), also known as jock itch and ringworm (tinea corporis)

Common yeast infections include thrush (vaginal candidiasis), fungal sweat rash (candidal intertrigo) and candidal nappy rash

 
Over-the-counter antifungals are the treatment of choice when it comes to treating common fungal infections. They can be divided into the following groups:

Imidazoles (e.g. clotrimazole, ketoconazole, miconazole, tolnaftate) are mainly used for vaginal thrush and fungal infections of the skin including athlete's foot and sweat rash. These compounds also have some activity against certain bacteria. A number of topical formats are available (e.g. creams, lotions, ointment, pessaries and sprays)

Triazoles (e.g. fluconazole) are used to treat vaginal thrush and are available in an oral format.

Imidazoles and triazoles work by interfering with the cell wall synthesis of the fungi by inhibiting the production of ergosterol, the main component in the yeast cell membrane. The antifungals inhibit 14-alphadimethylase, an enzyme that converts lanosterol to demethyl-lanosterol in the pathway to producing ergosterol. These antifungal agents are often classed as fungistatic because they
prevent the growth of the fungus.

Allylamines (e.g. terbinafine) are used for the treatment of fungal infections of the feet and groin. They work by killing the fungi by stopping the production of a substance essential for fungal cells to grow (and are often known as fungicidal). They are available in different formats, such as a cream or spray.

IMPORTANT:
  • Imidazoles or triazoles should not be taken with terfenadine
  • Antifungals should be used with caution in patients with liver disease
  • Fluconazole should not be used during pregnancy or while breastfeeding.

This website has been designed to enhance your knowledge about the most common fungal infections and their treatment, helping you and your staff to make correct assessments and highlighting the most effective ways of treating vaginal thrush, cystitis, athlete's foot, sweat rash and other fungal infections.

 
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