Antifungal drugs

Trimetrexate is reported to be incompatible with foscarnet. Trimetrexate should not be mixed with folinic acid or chloride ions, since precipitation occurs instantly.

Natamycin is a polyene antifungal active against Candida and Fusarium spp. In addition it is active against the protozoan Trichomonas vaginalis.

Miconazole is an imidazole antifungal with similar antimicrobial activity to that of ketoconazole. It also has some activity against Aspergillus spp., Cryptococcus neoformans, Pseudallescheria boydii, and some Gram-positive bacteria including staphylococci and streptococci.

Ketoconazole has a wide spectrum of antimicrobial activity including activity against Blastomyces dermatitidis, Candida spp., Coccidioides immitis, Epidermophyton floccosum, Histoplasma capsulatum, Malassezia spp., Microsporum canis, Paracoccidioides brasiliensis, Trichophyton mentagrophytes, and T. rubrum. Some strains of’Aspergillus spp., Cryptococcus neoformans, and Sporothrix schenckii are sensitive.

Itraconazole can be used to treat various superficial fungal infections, including dermatophytoses, pityriasis versicolor, and mucosal and cutaneous forms of candidosis.

Flucytosine is active against Candida spp., Cryptococcus neoformans, Cladosporium spp., and Fonsecaea spp. Some Aspergillus spp. have also been reported to be sensitive.

Econazole is an imidazole antifungal used topically in the treatment of superficial candidiasis and in dermatophytosis and pityriasis versicolor.

Clotrimazole is an imidazole antifungal used topically in superficial candidiasis, and in the skin infections pityriasis versicolor and dermatophytosis (see Skin Infections). Clotrimazole may also be used occasionally for symptomatic relie of the protozoal infection trichomoniasis when other drugs are contra-indicated.

Ciclopirox is an antifungal that is applied topically in the treatment of fungal skin and nail infections, including cutaneous candidiasis, dermatophytosis, pityriasis versicolor (see Skin Infections), and seborrhoeic dermatitis.

Butoconazole is an imidazole antifungal used locally as the nitrate in the treatment of vulvovaginal candidiasis. It is given intravaginally as a 100-mg pessary or as 5 g of a 2% cream for 3 consecutive nights a single application of the cream has also been used.