Antifungal activity of ketoconazole and other azoles againstMalassezia furfur in vitro andin vivo


Thein vitro activity of several antifungal agents (ketoconazole, miconazole, econazole, fenticonazole, itraconazole, fluconazole) in routine clinical use againstMalassezia furfur infections has been studied with freshly isolated strains ofM. furfur from pityriasis versicolor lesions. The results indicate that the drugs tested exert a good activity, and both ketoconazole and itraconazole appear very active (0.8 mg/l respectively). Hair samples from the beards of volunteer patients affected by pityriasis versicolor but otherwise healthy were examined to determine ketoconazole levels during oral therapy (one or two 200 mg tablets daily). It was shown that the drug progressively accumulates in the beard, reaching levels proportional to the dose administered, although blood levels did not increase in parallel. The study of drug concentration profile has evidenced a long ketoconazole persistence in the beard at therapeutic levels. In conclusion, the possibility of reaching high and lasting ketoconazole levels in the keratin layer of the epidermis indicates that systemic ketoconazole therapy could be useful for eradication ofM. furfur in patients affected by pityriasis versicolor.

This is a preview of subscription content, log in to check access.


  1. 1.

    Faergemann, J. Pityrosporum ovale and skin diseases. Keio J. Med. 42 (1993) 91–104.

    Google Scholar 

  2. 2.

    Faergemann, J., Djarv, L. Tinea versicolor treatment and prophylaxis and ketoconazole. Cutis 30 (1982) 542–545.

    Google Scholar 

  3. 3.

    Jones, H. E. Ketoconazole today. A review of clinical experience. ADIS Press, Manchester 1987, pp. 45–48.

    Google Scholar 

  4. 4.

    Faergemann, J. In Vitro andin vivo activities of ketoconazole and itraconazole againstPityrosporum orbiculare. Antimicrob. Agents Chemother. 26 (1984) 773–774.

    Google Scholar 

  5. 5.

    Strippoli, V., Piacentini, A., D'Auria, F. D., Simonetti, N.: Sull'attività antifungina esercitata dal ketoconazolo versoPityrosporum sp. Atti del 25° Congresso Nazionale di Microbiologia, Alghero 27–30 Settembre 1995.

  6. 6.

    Barnett, J. A., Payne, R. W., Yarrow, D.: YEAST: characteristics and identification (2nd ed.). Cambridge University Press 1990, p. 425.

  7. 7.

    Galgiani, J. N. Susceptibility testing of fungi: current status of the standardization process. Antimicrob. Agents Chemother. 37 (1993) 2517–2521.

    Google Scholar 

  8. 8.

    D'Auria, F. D., Simonetti, N., Strippoli, V. Increased itraconazole antifungal activity by agar diffusion test. J. Microb. Meth. 20 (1994) 47–54.

    Google Scholar 

  9. 9.

    Roberts, S. O. B. Pityrosporum orbiculare: incidence and distribution of clinical normal skin. Br. J. Dermatol. 81 (1969) 264–269.

    Google Scholar 

  10. 10.

    Rippon, J. W. Medical mycology, W. B. Saunders Company, Philadelphia 1988, pp. 154–159.

    Google Scholar 

  11. 11.

    Klotz, S. A., Hupper, M., Drutz, D. J. Pulmonary vasculitis on intralipid therapy. N. Engl. J. Med. 306 (1982) 994–997.

    Google Scholar 

  12. 12.

    Nenoff, P., Haustein, U. F. Der Effekt anti-seborrhoischer Substanzen gegenüberPityrosporum ovale “in vitro”. Hautarzt 45 (1994) 464–467.

    Google Scholar 

  13. 13.

    Richardson, M. D., Shankland, G. Enhanced phagocytosis and intracellular killing ofPityrosporum ovale by human neutrophils after exposure to ketoconazole is correlated to changes of yeast cell surface. Mycoses 34 (1991) 29–33.

    Google Scholar 

  14. 14.

    Schewach-Millet, M., Kahana, M., Levy, A., Yaron-Schiffer, O., Sommer, B., Shalish, L. Ketoconazole an effective treatment for disseminated pityriasis versicolor. Isr. J. Med. Sci. 20 (1984) 417–419.

    Google Scholar 

  15. 15.

    Epstein, E. H., Epstein, W. L. New cell formation in the human sebaceous gland. J. Invest. Dermatol. 46 (1966) 453–458.

    Google Scholar 

  16. 16.

    Wright, N. A. The cell proliferation kinetics of the epidermis. In:Goldsmith, L. A. (ed.): Biochemistry and physiology of the skin. Oxford Press, New York 1983, pp. 203–229.

    Google Scholar 

  17. 17.

    Harris, R., Jones, H. E., Artis, W. M. Orally administered ketoconazole: route of delivery to the human stratum corneum. Antimicrob. Agents Chemother. 24 (1983) 876–882.

    Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Prof. N. Simonetti.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Strippoli, V., Piacentini, A., D'Auria, F.D. et al. Antifungal activity of ketoconazole and other azoles againstMalassezia furfur in vitro andin vivo . Infection 25, 303–306 (1997).

Download citation


  • Fluconazole
  • Antifungal Activity
  • Itraconazole
  • Ketoconazole
  • Azole