Antifungal drugs are preparations used in the treatment of mycoses, or simply speaking, infectious diseases caused by pathogenic fungi. What are the types of antifungal medications? What are the indications and contraindications for their use? Are oral antifungal medications safe?

Antifungal drugsare preparations very often prescribed by doctors of virtually all specializations. However, one essential thing should be remembered - for antifungal therapy to be really effective, it should be preceded by thorough and reliable diagnostics and proper diagnosis. Diagnostics usually involves the use of both direct microscopic examinations of the collected material and stained preparations made of it.

The basis of diagnostics in the treatment of mycoses has been for many, many years now, cultivation on various diagnostic media that enables the differentiation of individual species on the basis of their morphological features, i.e. their appearance. The enzymatic properties of fungi and their sensitivity to individual drugs are also assessed. All this makes it possible to choose the right drug, and thus increase the effectiveness of treatment.

The most common pathogen in the human body isCandida albicans , which causes the so-called candidiasis (that is, thrush) of smooth skin and mucous membranes, as well as internal organs, central nervous system and lymph nodes.

Particularly dangerous for humans isCryptococcus neoformans , which causes cryptococcosis of internal organs and skin. In immunocompromised people, it can even cause life-threatening meningitis and encephalitis.

The human body is most endangered and susceptible to fungal infections when its immune system is weakened for some reason, e.g. by concomitant diseases or when there are other factors (including environmental factors) that increase the risk of infection.
The factors increasing the risk of mycosis include:

  • use of antibiotics, especially for a long time, with a broad spectrum of action and without the support of a probiotic
  • use of corticosteroids, cytostatics or immunosuppressants
  • applicationchemical contraceptives
  • immunity disorders in patients with diabetes, cancer, AIDS patients, chronic diseases such as asthma, rheumatic diseases, severe and prolonged stress
  • environmental contamination with fungicides that increase fungal resistance to drugs

Fungal infections can be of two types:

  • deep (systemic, organ)
  • superficial (mycosis of the nails, mucous membranes, mycosis of the smooth skin and tinea pedis, tinea versicolor)

Surface mycoses are most often accompanied by symptoms such as:

  • local tension, peeling, cracking and redness of the skin
  • formation of blisters or eruptions
  • persistent itching in lesions
  • and sometimes a very unpleasant and intense smell of sweat

And organ mycosis is an infection caused mainly by microorganisms that in a he althy person live in the body without causing any pathological changes or ailments. However, in immunocompromised patients, they can cause serious illnesses that require treatment, sometimes even in hospitals.

The most popular organ mycoses are:

  • thrush of the urinary tract
  • mycosis of the lungs
  • esophagus thrush
  • oral thrush
  • vaginal mycosis

Treatment of mycosis of organs is very difficult. It requires, first of all, the treatment of the primary disease, and then the fungal lesions themselves. Unfortunately, difficulties may arise already at the stage of diagnosis, due to the non-specific symptoms that fungal infection may cause. Therefore, most often the therapy is carried out in a hospital setting.

Substances with antifungal properties

  • Alliloamina

These are drugs that are administered orally. They are usually prescribed to treat skin and nail fungus.

These include:

  • Terbinafine - is active against many species of dermatophytes, molds, yeasts and other pathogenic fungi. The action of terbinafine, like that of other antifungal drugs, inhibits the synthesis of ergosterol, a component of the fungal cell membrane. When the cell membrane is damaged, the fungal cells die. When administered orally, it works against mycoses of the skin and mucous membranes, which cannot be treated only topically. The terbinafine solution can be used once in the case of athlete's foot. This drug when taken orally can unfortunately cause side effects such assuch as: gastrointestinal complaints, and sometimes also taste disturbances (fortunately, these changes are reversible). Terbinafine is also available over the counter in a number of preparations to be applied directly to the skin.
  • Naphtifine - it is used only topically in mycoses of the skin and mucous membranes. It is less effective against yeasts. It has an additional anti-inflammatory effect. It is used in candidiasis of the skin and tinea versicolor, fungal infections of the skin and skin folds (mycosis of the groin, mycosis of the smooth skin), tinea pedis of the hands and feet.
  • Azole derivatives

These are the substances most often used in the treatment of mycosis. Available both over and over the counter. Most importantly, they are as much as 80-95% effective. These include:

  • Clotrimazole - works against all pathogenic fungi attacking humans. It is practically not absorbed through the skin, and to a small extent it is absorbed through the mucous membranes. However, due to numerous side effects, it is only used topically.
  • Miconazole - mainly applied topically to the skin and mucous membranes of the mouth and throat. In addition to its antifungal and antiparasitic effects, it also has some antibacterial properties.
  • Econazole - used for the treatment of all kinds of cutaneous mycoses and in mixed infections, e.g. in vaginal or vulvar fungal infections or in tinea versicolor.
  • Ketoconazole - A popular antifungal drug that destroys yeast cellsMalassezia farfur . Heals seborrheic dermatitis, scalp dandruff, tinea versicolor. It gives satisfactory results in the treatment of systemic and superficial mycoses. It can be used prophylactically and in recurrent infections.
  • Fluconazole - is especially effective in the fight against yeasts and cryptococci. It is used to treat vaginal yeast infection, as well as the mucous membranes of the throat and mouth. It also shows bactericidal activity against gram-positive bacteria. The drug is intended for topical use only.
  • Fenticonazole - a drug that acts on yeast infection of the mucous membranes of the genital organs.
  • Voriconazole - has a broad spectrum of activity, i.e. it is active against many species of fungi as well as speed of action, therefore it is usually prescribed as the first antifungal drug for the treatment of life-threatening mycoses.
  • Itraconazole - an antifungal drug for surface and systemic mycoses. In the oral form, it is used in the treatment of mycoses of the vagina and vulva, mycoses of the skin and nails, fungal infections of the cornea, candidiasisoral cavity, tinea versicolor and systemic mycoses.
  • Pyridinone derivatives
  • Ciclopiroxolamine - has a very wide range of antifungal and antibacterial properties, and, importantly, has anti-allergic and anti-inflammatory properties. It is used in the treatment of mycoses of smooth and hairy skin, especially vaginal and vulvar infections and skin around the anus, in onychomycosis. It is an ingredient of anti-dandruff shampoos. However, it should not be applied to wounds and irritated skin.
  • Disinfectants - have a fungistatic or fungicidal effect in the local treatment of fungal skin diseases. These include, for example, iodine, thymol, amphoteric soaps, salicylic and benzoic acid, hydroxycholine, benzoamidine, thiadiazine derivatives and many others. However, most of these drugs have now been superseded by newer and better-studied antifungal drugs.
  • Chlormidazole hydrochloride - has a fungistatic effect onEpidermophyton ,TrichophytonandMicrosporon . It can be used in the form of a combined preparation with salicylic acid in fungal infections of the skin and onychomycosis.
  • Boric acid

Boric acid is used in the treatment of vaginal mycosis. The therapy uses ready-made globules, and the treatment lasts about 2 weeks. The effectiveness of combating vaginal mycosis with boric acid is estimated at about 70 percent. However, if vaginal mycosis recurs, the entire treatment should be repeated. Boric acid is also often an ingredient in popular vaginal rinses.

Antifungal plant ingredients

Not only chemical preparations have an antifungal effect, also those of plant origin have such an effect. However, it should be remembered that their action may be insufficient in the case of extensive mycoses that require medical consultation.
Plants showing antifungal activity:

  • Sage ( Salvia officinalis ) - the raw material of the sage leaf has some antifungal properties. The infusion can be used for rinsing in the mouth and throat thrush.
  • European Lebanese ( Origanum vulgare ) - most likely the oil of Lebanon (oregano oil) supports the body in the fight against mycosis. It is believed to be particularly active againstCandida albicansand therefore may prove effective in the treatment of oral candidiasis.
  • Common garlic (Allium sativum) - garlic thanksthe content of sulfur compounds is bactericidal and antifungal. Garlic extract is a component of the lotion used topically in the treatment of mycoses of the skin.
  • Olive tree leaf and extract ( Olea europaea ) - due to the oleuropein content, it is especially recommended in the fight against fungi, bacteria and viruses. It is effective against fungiCandida albicansand against mycoses of the feet, nails and skin.
  • Tea tree oil ( Melaleuca alternifolia ) - can support people struggling with interdigital mycosis and onychomycosis, caused by both dermatophytes and yeast fungi. When used regularly, it prevents relapses.

In order for the herbs to support the treatment of mycosis, they should be properly prepared and dosed. It is best to consult a specialist, or follow the manufacturer's recommendations contained in the leaflet, remembering that, like any medicine, herbal preparations may also cause side effects or interact with other preparations.

Herbal antifungal preparations are available in the form of ready-made teas, decoctions, infusions or alcohol extracts, as well as in the form of tablets and capsules.

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