Clotrimazole - instruction to this antifungal drug developed by numerous manufacturers producing it under their own brand names: antifungol, vikaderm, Gine-Lotra, imide, yenamazol, kandibene, Candida, Candida B kandizol, kanesten; Canisius, klomazol ,, clotrimazole, klofan, lotriderm, Lotrimin, menstan, mikohau, Ovis, faktodin, funginal, fungitsip.

The mechanism of action of clotrimazole

Clotrimazole - an antifungal drug for topical and local application of a group of imidazole derivatives. Clotrimazole produced in the following dosage forms: tablets vaginal cream for external use, ointment, gel, lotion, solution for external use (for spraying an aerosol container), a solution for oral and lozenges.

The mechanism of action involves a violation of clotrimazole education fungal cells of the active substance of ergosterol, which is part of the cell membranes of fungi. In its absence, in the membranes of fungi changes occur, but becomes permeable to many other substances harmful for it, which leads to the destruction of cells. In addition, Clotrimazole inhibits the activity of certain enzymes, and this also contributes to the accumulation of harmful fungi in cells for their materials.

Sensitivity to clotrimazole show almost all pathogenic fungi that cause infections in people - dermatophytes (fungi causing microspores trichophytosis and athlete), yeast (including fungi genus Candida) and molds, agents of multi-colored lichen, actinomycetes, Gram-positive bacteria (Staphylococcus , Streptococcus), Gram-negative bacteria (Gardnerella, Haemophilus influenzae), Trichomonas Trichomonas - leads to infertility   and others.

In small concentrations of clotrimazole inhibits the vital functions of fungi in large - leads to the destruction of their cells. Clotrimazole is available only in the form of dosage forms for topical and external use. He hardly absorbed into the bloodstream when applied topically, when administered into the vagina absorbed about 3% of active principle. Therefore, he has almost no general (systemic) action.

When applied to the skin clotrimazole main part is concentrated in the outer layers, however, and in the middle layer (dermis) is created therapeutic concentration of the drug. When applied on the nails clotrimazole accumulated in all of its layers, including keratin.

Indications and contraindications

Depending on the dosage form of clotrimazole is used for all fungal and bacterial and fungal diseases of the skin, skin folds, scalp, feet, nails and mucous membranes caused by microorganisms sensitive to it:

• dermatophytes - Microsporum, Trichophyton, jock itch Jock itch: fungal infection   and athlete's foot;
• otrubevidnom (multicolored) versicolor, erythrasma;
• candidiasis of the skin and mucous membranes (including genital candidiasis and candidiasis of the oral cavity and pharynx);
• fungal infections of the nails;
• fungal diseases complicated by additional bacterial infections;
• genital candidiasis, trichomoniasis complicated.

Clotrimazole is also used for the treatment of the birth canal before delivery. He is active, including the causative agents of infection, insensitive to nystatin and other locally acting anti-fungal.

Contraindications for use of clotrimazole are idiosyncrasy components of the drug by the body of the patient and the first trimester of pregnancy. In laboratory studies it was found that the application of clotrimazole in high doses, it has a toxic effect on the fetus. Hence the need for the appointment of clotrimazole in the second and third trimesters of pregnancy should be decided by the doctor individually.

It is not known whether clotrimazole with breast milk, so the baby during feeding Breastfeeding - a personal choice   breast should be used with caution. No dosage forms clotrimazole not apply to the eye diseases.

Vaginal tablets and vaginal cream is not recommended for use during menstruation.

The side effects and the possibility of an overdose

Side effects at the local and external use clotrimazole rare. However, when applied to skin irritation and possible allergic reactions such as swelling, redness, itching and burning. Sometimes the swelling and pain arise in the mucous membranes.

No cases of overdose of clotrimazole was revealed. But if clotrimazole accidentally falls inside, it can result in severe poisoning. In such cases, you should immediately wash the stomach to take a few tablets of activated charcoal Activated carbon - old but indispensable   and call an ambulance.

Galina Romanenko

Microsporia - a fungal disease that affects the skin, hair and nails are very rare cases. Because of the manifestations of the disease is also called "ringworm." Among the lesions caused by fungi, microsporia most common and most often occurs in children.

How do you get infected?

Fungi that cause microspores are two types: antropofilnymi and zooantropofilnomu. Antropofilnymi parasitic fungi only on the skin and hair of humans. To this group belong rusty mikrosporium (Microsporium ferrugineum) and mikrosporium Oduena (Microsporium Audonii). Zooantropofilnye fungus attacks the animals and can be transmitted from person to them. This type of mushrooms are dog mikrosporium (Microsporium canis) and cat mikrosporium (Microsporium folineum).

Infection antropofilnymi mushrooms occurs through direct contact with a sick person or through infected everyday objects, which he enjoyed. Rusty mikrosporium - the most contagious of all known fungi, so the appearance of even one sick child in the children's collective outbreak occurs.

Infected zooantropofilnymi views mikrosporiuma possible from both cats and dogs, as well as through positive things (toys, hats, bed linens). These fungi are very persistent in the environment. Even without mikrosporium animal being in skin flakes retain their viability for up to seven years, and wool - to ten.

Signs microsporia

Latent (incubation) period of the disease lasts from two weeks to three months. When zooantropofilnoy microsporia scalp appear one or two large oval or round the hearth with clear boundaries. Next to them is several smaller foci. In these areas, the hair broken off at the level of six to eight millimeters from roots. Remains of hair tightly covered with white spores of the fungus, while the skin is hyperemic (flushed) with a lot of gray scales. Inflammatory changes on the scalp is usually mild, but some patients have suppurative forms of the disease.

If the affected smooth skin on the face, legs, torso, then the deposition of the erythematous patches with raised edges in the form of a roller. Last covered with pustules, vesicles, scales or purulent crusts. Affected foci have clear contours and a rounded or oval shape. The center of the rash always somewhat paler than their edges.

When microsporia, which is called the rusty mikrosporiumom, pockets are found on the scalp, on the border with smooth skin. The affected areas have irregular outlines with fuzzy edges on their surface noticeably peeling. Hair break off high and at different levels, but there are apparently healthy. The remaining fragments are covered with spores of the fungus in the form of a case. On a smooth skin can appear ring red-pink color, which are written into one another.

Diagnostics

If signs microsporia need to consult a dermatologist. Diagnosis of the disease is made after carrying out the following studies:

• Microscopic. When struck by a smooth skin, the flakes are taken from the surface under a microscope revealed them thin crimped yarn fungus. With involvement of the hair are exploring their fragments, which are visible on the surface of small disputes.
• Fluorescent. This research is carried out in a darkened room using a special lamp Wood. For hair that struck mikrosporiumom, characterized by emerald-green glow. The described method allows to detect the presence of damaged hair, to evaluate the results of the treatment and control the condition of the people who were in contact with patients.
• Cultures. This method of diagnosis is carried out if the results of microscopic and luminescence studies were positive. A study to determine the type of fungus that is necessary for proper treatment. To do this, scales and hair are placed on a nutrient medium, where after 3 days you can see the growth of colonies mikrosporiuma.

Treatment and prevention

For the treatment of microsporia smooth skin where the hair is not amazed appointed antifungals for topical use. These include ointments such as ketoconazole, clotrimazole Clotrimazole - effective against bacteria , Bifonazole. You can also lubricate the affected centers of two percent alcohol tincture of iodine. In marked inflammation recommended combination of drugs that contain hormones (travokort, mikozolon). If you joined a bacterial infection, it copes well with her cream triderm Triderm - care for skin diseases .

The most effective means to treat microsporia scalp - an antibiotic Antibiotics - whether they will help you in the foreseeable future?   griseofulvin. The drug is taken daily three times a day during meals with a teaspoon of vegetable oil, which increases the solubility and increases the effect. Such continuous treatment with griseofulvin continues until the first negative result of the analysis on mushrooms, then an antibiotic is used less frequently. The drug is contraindicated in children with hepatitis Hepatitis - the scourge of our time   and other liver diseases. Another equally effective drug is terbinafine (Lamisil). At the same time you need to shave every week, and apply ointment listed. Treatment usually continue for up to six weeks.

Microsporia prevention is early detection of patients, isolation and treatment. To this end, all child care institutions should be regularly carried out medical examinations. In identifying the sick child he was sent to a specialized hospital and disinfect things. After that, relatives and people in contact with him must necessarily be examined. Sick pets - a common source of infection, so they should also conduct a special anti-fungal medication.