Triple-Action Antifungal Topicals, Microbiologist's Alarm

Today, we are witnessing the development and marketing of triple action antifungals for the treatment of superficial mycoses. It is a mixture of antifungals, antibiotics and anti-inflammatory. The problem of this research was to verify the effects of this mixture as to its effectiveness on superficial mycoses. Thus, we set ourselves the following objectives: to identify the antifungals in the pharmacies of the cities of Likasi, Lubumbashi and Kolwezi, to determine their composition and to discuss this composition with the existing literature.

Through a cross-sectional study, we identified thirty-four different antifungals in 588 pharmacies, of which 16 or 47.05% are triple action and made up of Azoles as antifungal, the antibiotic gentamicin, and corticosteroids as anti-inflammatory, alongside polyene, Echinocandins and flucytosine. It is the combination of antifungals with conventional non-antifungal agents reoriented for their action on the growth of fungi. They consist of antibacterial drugs and steroidal anti-inflammatories. This reorientation was supposed to have excellent antifungal activity and could prevent resistance. However, the presence of the antibiotic will reduce the composition of the colonizing microbiota and promote fungal growth and enhance fungal pathogenicity indirectly and the corticosteroid component may interfere with the therapeutic actions of the antifungal agent and may accelerate fungal growth, due to a decrease in the host's local immunological reaction, so that the underlying infection may persist, and the dermatophytes may even acquire the ability to invade the deeper tissues. So, in support, it would be interesting to favor antifungals without combinations than those combining antibiotics and anti-inflammatory which has an extremely high rate of recurrence.