Topical antifungal treatment

The polyene antifungal agents, nystatin and amphotericin B, are well established and relatively free from side-effects when used locally. They are available in various forms, such as lozenges, pastilles, creams, and suspensions.

Unfortunately, patient compliance is often poor with these preparations, which may take a while to dissolve in the mouth (for example, pastilles and lozenges) and have a a distinctive taste. The newer azoles have very useful properties, although resistance is rather more commonly met and may be problematic in the future, particularly in the immunocompromised patient. The locally active agent, miconazole is available as an oral gel or cream.

Pharmaceutical Forms

In order to assure topic application of antifungal agents, conventional lozenge, mouthwash, or gel would be the simplest dosage forms for the delivery of drugs in the buccal cavity, but these conventional dosage forms had the disadvantage of an initial burst of salivary concentration followed by a rapid decrease. A lozenge produced effective salivary drug levels for more than one hour but repeated administration was restricted due to systemic toxicity coming from the large quantity of ingested drug. The action of mouthwashes was even more transient than that of lozenges, and gels/pastes were difficult to retain in the mouth.

In case of oral fungal infections, a prolonged therapy with antifungal agent was required, and some papers documented prolonged release of antifungal agent from buccal devices in the form of an adhesive tablets.

Ex. 21. Compose 4-5 interrogative sentences using the Present Continuous Tense.

Ex. 22. Speak about the topical antifungal treatment.

Overview

Antibiotic is a chemical substance that inhibits the growth of other microorganisms. The term is used to refer to substances with anti-bacterial, anti-fungal, or anti-parasitical activity. Antibiotics can be divided into two groups: bactericidal and bacteriostatic. Bactericidal antibiotics destroy bacteria, and bacteriostatic antibiotics prevent bacteria from multiplying. Antibiotics are used to treat serious bacterial infections. Each antibiotic is effective only against certain bacteria. Usually, antibiotics are given by mouth, while intravenous antibiotics are used in more serious cases. Antibiotics may also sometimes be administered topically.

Lesson 18

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