So-called antimycotics are used in the treatment of fungal infections. They can be applied either topically (i.e. locally) or systemically (in the body). Sometimes both forms of therapy are also combined. Several active substances are available, which differ in their mode of action.
Here you will find further information and selected antifungal specialists for combating fungal diseases.
Antifungals are drugs used to combat fungal infestation (medically: mycosis).
They can be targeted at a specific type of fungus and combat it efficiently. They are then referred to as narrow-spectrum antifungals.
Other antifungal agents are not specialized for a specific fungal pathogen, but damage fungi in general. In this case, it is a broad-spectrum antifungal.
Antifungals can effectively combat a fungal infestation if they are used correctly. You should also follow certain hygiene rules to prevent the pathogens from spreading further. These include, for example:
The active ingredients of antifungal agents can have different effects on the fungus:
Basically, mycotics act on the production centers of fungal cells, their cell membranes. They do not kill fungal cells directly, but only change the "blueprint" of the substances produced in the cell membranes.
Active substances such as imidazoles and triazoles block an important enzyme. Without this enzyme, the fungal cells produce the wrong building material, which disrupts the metabolic processes in the fungus. As a result, the fungus can no longer reproduce. The fungal infestation does not spread any further and the body gradually rejects it through skin renewal. The fungus is thus treated fungistatically.
Some antifungal agents of the imidazole group, such as clotrimazole and miconazole, cause the production of strongly modified building materials. These can no longer be used to build dense fungal cell membranes. As a result, the inside of the cell leaks out and the fungus eventually dies. This is why clotrimazole and miconazole are also known as fungicidal antifungals.
Athlete's foot pathogens love the warm, moist environment of poorly ventilated sports shoes © misalukic | AdobeStock
In fungal therapy, a distinction is also made between topical and systemic applications. For some fungal diseases, a combination of both forms of therapy is also suitable.
Topical antifungals are applied locally directly to the surface of the body. These are usually
The patient applies the antimycotic directly to the fungal infection.
This form of fungal therapy is useful for fungal infections that are not too widespread on the surface of the body in the area of
They prove their worth, for example, against
Topical therapies can efficiently treat localized fungal infestations. They do not affect the whole body, but can only have local side effects, such as skin reactions.
Accompanying symptoms of mycosis such as itching or burning are treated with the help of supportive medication. Even with successful antifungal therapy, these local symptoms often only disappear after the skin cells have regenerated. This can take several weeks.
Fungal infestation can spread further, especially in people with a weak immune system. Often affected are
In a systemic fungal disease, the fungal pathogens are found in the blood and can therefore infect any organ. Topical therapy is then no longer sufficient.
Other reasons for systemic antifungal therapy are
In these cases, the antimycotics are administered as part of systemic therapy. The patient receives the antimycotics in the form of tablets or infusions. Capsules or juice can also be used for systemic therapy.
The antimycotic enters the bloodstream and acts throughout the entire body. The medication usually contains active ingredients from the groups of
All three drug classes use different mechanisms to damage the cell wall components of the fungal pathogens. In this way, they prevent their growth.
Not every patient is suitable for systemic therapy. People with liver disease and pregnant women are excluded.
Systemic antifungal therapy can also have side effects:
However, modern drugs used in systemic therapy are well tolerated and rarely cause side effects.
The success of treatment for mycosis depends crucially on the use of the right medication. The treatment can therefore only be as good as the previous diagnosis.
In principle, many topical antifungal medications are available over the counter in pharmacies. A visit to the doctor is therefore not necessary in every case. Some fungal infestations can also be easily diagnosed by laypeople. If the infestation is not yet very advanced, there is nothing to stop you from treating it yourself.
Many fungal diseases can be treated yourself with over-the-counter antifungals © Siniehina | AdobeStock
Under no circumstances should you postpone treatment. A fungus that affects large areas of the body can cause serious damage to your health. Without effective medication, the infection can lead to systemic mycosis. Early topical treatment in accordance with expert recommendations stops the development of the fungus and prevents the disease from progressing to a more serious stage.
A visit to the doctor is necessary in these cases:
The doctor will first carry out a careful diagnosis to identify the pathogen. In some cases, the site of infection indicates the fungus involved in the disease. Vaginal thrush, for example, is caused by the yeast Candida albicans in 90 percent of cases.
To identify the exact pathogen, the doctor can carry out a pathogen test. He takes a small sample of the infected tissue using a swab. The isolated fungal pathogen is cultured in the laboratory. After one to four weeks, the fungus has developed sufficiently. An examination under the microscope then reveals the type of fungus in the sample.
The doctor then selects an optimally effective medication and determines the duration of the fungal treatment.
Whether with or without a doctor, the treatment of mycosis requires the patient's consistent adherence to therapy. A successful cure can only be achieved if the frequency and duration of treatment are strictly adhered to. Always follow the instructions in the package leaflet or the instructions of your doctor.
Treatment must be continued until the end, even if fungal infestation is no longer visible. In the case of a fungal infection, freedom from symptoms is not yet the goal of treatment. Fungal pathogens could survive in the skin and multiply again later if treatment is stopped too early.
Nystatin is the classic antifungal drug. Back in 1950, two American women discovered an effective antifungal agent that is still used worldwide today. They isolated a natural antifungal agent from bacteria, which serves as a weapon against fungal infestation.
Nystatin is one of the few highly effective antifungal agents that have almost no side effects. The agent makes the outer wall of the fungal cell permeable and disrupts its respiration.
The nystatin molecules are so large that they cannot penetrate the intestinal wall. As a result, the substance in the antifungal agent leaves the digestive tract unchanged. This is why even pregnant women can use the antifungal agent Nystatin.
The antifungal agent against yeast fungi is used on the skin as an ointment, cream or paste. Nystatin is used as a vaginal suppository for vaginal yeast infections.
Chemically closely related to nystatin are the antifungal agents natamycin and ampotericin B. These antifungals work in the same way as Nystatin. Sometimes doctors also prescribe the antifungal agent amphitericin B as an infusion solution. In this way, the antifungal agent reaches the intestine via the bloodstream and kills the fungi there.
However, this antifungal treatment is only recommended for severe fungal infestations if other medication is not effective. It can cause serious side effects.
If fungi have
intestinal medication alone will no longer help. The same applies to stubborn fungal infections that have reached deep layers of the skin or nail fungus.
Many doctors then prescribe antifungals that penetrate the intestinal wall and act throughout the entire organism. However, this systematic therapy can cause serious side effects.
One of these antifungals is ketoconazole. This antifungal agent occasionally causes kidney damage and is now rarely used internally.
Imidazoles are another group of antifungals and, together with the triazoles, form the azole antifungals. Azole antifungals are the largest group of antifungals for fungal infections.
They have a considerable range of efficacy, meaning that they can be used against many different pathogens. Imidazoles and triazoles are generally used to treat fungal infections
are used. As antifungal agents, they are generally used externally.
The following are used externally or locally
In various suitable dosage forms, these antifungal agents can be applied to the skin
is possible. The antifungals are very effective and well tolerated in these areas.
Most of the antifungal agents mentioned must be applied twice a day. Modern antifungals such as bifonazole or croconazole only need to be applied once a day.
However, ketoconazole and miconazole can also be used for internal treatment. Miconazole can be injected directly into the bloodstream as an infusion in hospital.
Ketoconazole is less suitable for injections and infusions. However, like miconazole, it can be used against fungal infections of the stomach and intestinal mucosa.
Antifungals taken internally, such as imidazole , can cause severe side effects. For this reason, better tolerated antifungals, such as triazoles, are currently preferred. These include the antifungals
The antifungal agent itraconazole mainly combats
Fluconazole is particularly effective as an antifungal agent against yeast fungi and cryptococci.
The antifungal agent voriconazole combats Candida strains.
