학술논문
Miconazole for the treatment of vulvovaginal candidiasis. In vitro , in vivo and clinical results. Review of the literature.
Document Type
Academic Journal
Author
Regidor PA; Exeltis Europe, Ismaning, Germany.; Thamkhantho M; The Royal Thai College of Obstetricians and Gynaecologists, Bangkok, Thailand.; Chayachinda C; Department of Obstetrics and Gynaecology, Faculty of Medicine, Unit of Gynaecologic Infectious Diseases and Female Sexually Transmitted Infections, Siriraj Hospital, Mahidol University, Bangkok, Thailand.; Palacios S; Instituto Palacios, Salud y Medicina de la Mujer, Madrid, Spain.
Source
Publisher: Informa Healthcare Country of Publication: England NLM ID: 8309140 Publication Model: Print Cited Medium: Internet ISSN: 1364-6893 (Electronic) Linking ISSN: 01443615 NLM ISO Abbreviation: J Obstet Gynaecol Subsets: MEDLINE
Subject
Language
English
Abstract
At concentrations achieved following systemic administration, the primary effect of imidazoles and triazoles on fungi is inhibition of 14-α-sterol demethylase, a microsomal cytochrome P450 (CYP) enzyme. Imidazoles and triazoles impair the biosynthesis of ergosterol for the cytoplasmic membrane and lead to the accumulation of 14-α-methyl sterols. The synthetic imidazole miconazole is additionally able to increase intracellular reactive oxygen species, at least in part through inhibition of fungal catalase and peroxidase. This unique feature of miconazole is probably the basis for its fungicidal activity in C. albicans , in addition to the fungistatic mode of action. Studies show that miconazole is superior to nystatin treatment and demonstrate its impact as one of the best options in managing vulvovaginal candidiasis. Regarding recurrent vulvovaginal candidiasis, several new drugs are currently developed to ensure effective treatment also for this group of patients.