Degreef H
Université Catholique de Leuven, Hôpital Universitaire, Département de Dermatologie, Belgique.
Ann Dermatol Venereol. 1993;120(1):21-31.
New antifungals for topical and systemic treatment of superficial mycotic infections of the skin and nails have been developed in the last decade. Terconazole is a potent drug in treating topically vaginal candidiasis. Amorolfine belongs to the chemical class of morpholine derivatives and is topically active against a wide range of fungal infections. Also naftifine and terbinafine, two new allylamines, can be used in local therapy of superficial mycotic infections of the skin. Itraconazole and fluconazole are both new triazoles for systemic use. Itraconazole has a broader spectrum and a higher safety profile than ketoconazole, caused by a greater specificity for the fungal cytochrome P 450 14-alpha-demethylase. The pharmacokinetic properties result in shorter treatments, even in onychomycosis. The mode of action of fluconazole is the same as for the azoles. This drug was being studied particularly in systemic mycoses and mucosal candidiasis. The activity of orally terbinafine is directed mainly against dermatophytes. This drug offers new therapeutic possibilities in the treatment of onychomycosis, caused by dermatophytes.
在过去十年中，已开发出用于皮肤和指甲浅表真菌感染的局部和全身治疗的新型抗真菌药。特康唑是治疗局部阴道念珠菌病的有效药物。阿莫罗芬属于吗啉衍生物化学类别，对多种真菌感染具有局部活性。同样，萘替芬和特比萘芬这两种新型烯丙胺类药物可用于皮肤浅表真菌感染的局部治疗。伊曲康唑和氟康唑都是用于全身治疗的新型三唑类药物。由于对真菌细胞色素P 450 14-α-脱甲基酶具有更高的特异性，伊曲康唑比酮康唑具有更广泛的抗菌谱和更高的安全性。其药代动力学特性使得治疗时间缩短，即使在治疗甲癣时也是如此。氟康唑的作用方式与唑类相同。该药物尤其用于全身真菌病和黏膜念珠菌病的研究。口服特比萘芬的活性主要针对皮肤癣菌。该药物为皮肤癣菌引起的甲癣治疗提供了新的治疗可能性。
