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.
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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). https://doi.org/10.1007/BF01720401
- Antifungal Activity