A group of drugs that is used to treat infections caused by fungi
Various drugs are available to treat fungal infections. These antifungal drugs have a wide range of uses because disorders resulting from fungal infections can occur on or in many different parts of the body. For example, treatment may be needed for infections of superficial areas such as the skin, nails, or genitals; rarely, internal organs, such as the heart or lungs, may also be infected.
Most antifungals work by damaging the walls of fungal cells. This causes vital substances within the cell to leak out, destroying the fungus.
Why are they used?
Antifungal preparations are frequently used to treat minor fungal infections of the skin, such as athlete’s foot and ringworm, or of the nails (see Nail abnormalities). These types of drug are also effective against candidiasis, a common fungal infection that can affect moist areas of the body, in particular the mucous membranes that line the mouth (see Oral thrush) and the vagina (see Vaginal thrush).
Antifungal drugs may also be used for the long-term treatment of potentially serious fungal infections such as aspergillosis, which may affect the lungs and spread to other organs. People with reduced immunity, such as those who have HIV infection or AIDS, are at high risk from severe fungal infections, and in such cases antifungal drugs may be life-saving.
How are they used?
If you have a fungal infection of the skin, your doctor may prescribe a cream containing an antifungal such as ketoconazole. Symptoms normally start to improve within about a week. However, you should continue the treatment for the full period recommended by your doctor to ensure that the infection has been eradicated. If topical treatment is ineffective, an oral antifungal drug may be prescribed. Nail infections are treated with a drug such as terbinafine, taken orally for several months. It may take much longer than this for the infected part of the nail to grow out. Dandruff may be treated with shampoo containing ketoconazole.
Drugs used to treat vaginal thrush are available over the counter. Commonly used drugs include fluconazole and clotrimazole. Fluconazole is taken orally; clotrimazole is inserted into the vagina, either as a cream using a special applicator or in the form of a pessary. Some preparations are available as a single dose; others need a 3-day course of treatment. Oral thrush is treated by antifungal drugs given as lozenges, which are dissolved slowly in the mouth, or as gels or solutions applied directly to the affected area.
Serious infections of internal organs need to be treated with potent antifungal drugs, such as amphotericin, which are initially given intravenously. Further treatment with oral drugs may then be continued for months.
What are the side effects?
Antifungal drugs used topically on the skin, scalp, or mucous membranes do not often cause side effects, but some irritation may occur. Nystatin used as a cream may stain clothing yellow.
Potent oral antifungal drugs may cause nausea and vomiting. Less frequently, serious side effects may occur, such as kidney damage and blood disorders. Oral treatment with the drug ketoconazole may cause liver damage.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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