Antifungal Agents for Dermatomycoses / 한양의대학술지

ABSTRACT

The development of selective and safe antifungal agents are relatively delayed, compared to that of other antibiotics. The reasons are the relatively lesser interest of pharmaceutical companies because of the fewer occurrence of fungal disease and the apparent lack of a highly selective fungal target, not present in other eukaryotic (including mammalian) cells. Until the 1940s, fungal skin infection was treated by keratinolytics, antiseptics, and antibacterial chemicals. The first selective antifungal agent was polylene compounds in the early 1950s, which were topical nystatin and fungizone (amphotericin-B). In 1958, the first oral fungal agents, 'griseofulvin', as developed and have been used effectively to tinea capitis and other dermatophytes. Between the late 1960s and early 1970s, the azole compound, 'the real broad spectrum antifungal agents' was introduced, and clotrimazole was the first topical azole compound followed, by miconazole and econazole. Ketoconazole was released in early 1980s and it was the first real oral antifungal agent for systemic and superficial fungal infections. However, because of serious side effects of symptomatic hepatic injury, its use was replaced by triazole antifungal agents such as itraconazole and fluconazole. Triazole was more safe and effective, and caused advancement in the treatment of onychomycosis. In addition, terbinafine 'belonging to the allylamine compounds and developed in 1984', has been approved as a very potent antifungal agent for dermatophytes and also is being used widely to cutaneous infection by candidia species and some molds.