卫凤莲硝酸舍他康唑的临床应用研究进展

摘要/Abstract

摘要：

硝酸舍他康唑(sertaconazole)是一种新型、广谱、高效的外用唑类抗真菌药。本文就其药理作用、抗炎、止痒、抗真菌临床疗效及安全性评价等方面加以综述。新的剂型-微乳凝胶,增强皮肤渗透性和存留时间,而且能减少对皮肤的刺激。外用硝酸舍他康唑治疗皮肤癣菌病和浅表念珠菌感染见效快,治愈率高,疗程短。根据药代动力学,舍他康唑只需每日用药一次,加之其止痒活性,增加了患者依从性,从而提高了临床治愈率。最新临床研究发现外用硝酸舍他康唑乳膏对脂溢性皮炎、特应性皮炎有良好的疗效。

关键词: 硝酸舍他康唑, 抗真菌药, 皮肤癣菌病, 浅表念珠菌病, 脂溢性皮炎, 特应性皮炎

Abstract:

Sertaconazole nitrate is a new broad-spectrum, efficient topical azole antifungal.This paper summarizes its pharmacological action, anti-inflammatory, antipruritic action, antifungal activity, the latest clinical efficacy and safety evaluation in the treatment of dermatophytoses, superficial candidiasis, seborrheic dermatitis and atopic dermatitis etc.Compared with miconazole, clotrimazole, terbinafine etc, sertaconazole cream can provide a better efficacy and tolerability in the treatment of skin tinea and superficial Candidal infections.Its antipruritic action and once-daily application in the light of its pharmacokinetics increase patient adherence and the cure rate.A topical microemulsion-based hydrogel has been developed to enhance permeation of sertaconazole for effective eradication of cutaneous fungal infection.The latest clinical studies suggest that sertaconazole cream may be an excellent alternative therapeutic modality for treating seborrheic dermatitis and atopic dermatitis.

Key words: Sertaconazole nitrate, antifungal, dermatophytoses, superficial candidiasis, seborrheic dermatitis, atopic dermatitis

中图分类号:

R978.5

孙玉鲁, 张锐利, 苏芳. 卫凤莲硝酸舍他康唑的临床应用研究进展[J]. 中国真菌学杂志, 2015, 10(4): 252-256.

SUN Yu-lu, ZHANG Rui-li, SU Fang. Advances in the clinical application of sertaconazole nitrate[J]. Chinese Journal of Mycology, 2015, 10(4): 252-256.

参考文献

[1] Raga MM,Moreno-Mañas M,Cuberes MR,et al.Synthesis and antimycotic activity of (benzo[b]thienyl) methyl ethers of 1-(2,4-dichlorophenyl)-2-(1H-imidazol-1-yl)-ethanol and of (Z)-1-(2,4-dichlorophenyl)-2-(1H-imidazol-1-yl) ethanone oxime[J].Arzneimittel-Forschung,1992,42(5A):691-694.
[2] Liebel F,Lyte P,Garay M,et al.Anti-inflammatory and anti-itch activity of sertaconazole nitrate[J].Arch Dermatol Res,2006,298(4):191-199.
[3] Sur R,Babad JM,Garay M,et al.Anti-inflammatory activity of sertaconazole nitrate is mediated via activation of a p38-COX-2-PGE2 pathway[J].J Invest Dermatol,2008,128(2):336-344.
[4] Holzer P.Neurogenic vasodilatation and plasma leakage in the skin[J].Gen Pharmacol,1998,30(1):5-11.
[5] Trichophyton E.Observational evaluation of sertaconazole nitrate cream 2% in the treatment of pruritus related to tinea pedis[J].Cutis,2009,84(5):279-283.
[6] Carrillo-Muñoz AJ,Tur-Tur C,Cárdenes DC,et al.Sertaconazole nitrate shows fungicidal and fungistatic activities against Trichophyton rubrum,Trichophyton mentagrophytes,and Epidermophyton floccosum,causative agents of tinea pedis[J].Antimicrob Agents Chemother,2011,55(9):4420-4421.
[7] Carrillo-Muñoz AJ,Guglietta A,Palacín C,et al.In vitro antifungal activity of sertaconazole compared with nine other drugs against 250 clinical isolates of dermatophytes and Scopulariopsis brevicaulis[J].Chemotherapy,2004,50(6):308-313.
[8] Carrillo-Muñoz AJ,Fernández-Torres B,Cárdenes DC,et al.In vitro activity of sertaconazole against dermatophyte isolates with reduced fluconazole susceptibility[J].Chemotherapy,2003,49(5):248-251.
[9] 王进.硝酸舍他康唑软膏体外抗真菌活性研究[J].中国热带医学,2008,8(9):1503-1504.
[10] Carrilo-Muñoz AJ,Tur C,Torres J.In-vitro antifungal activity of sertaconazole,bifonazole,ketoconazole,and miconazole against yeasts of the Candida genus[J].J Antimicrob Chemother,1996,37(4):815-819.
[11] 刘军,刘维达,沈永年,等.硝酸舍他康唑栓剂体内药效学实验研究[J].中国皮肤性病学杂志,2005,19(7):398-400.
[12] Susilo R,Korting HC,Greb W,et al.Nail penetration of sertaconazole with a sertaconazole-containing nail patch formulation[J].Am J Clin Dermatol,2006,7(4):259-262.
[13] Sahoo S,Pani NR,Sahoo SK.Effect of microemulsion in topical sertaconazole hydrogel:In vitro and in vivo study[J].Drug Deliv,2014:1-8.
[14] Savin R,Jorizzo J.The safety and efficacy of sertaconazole nitrate cream 2% for tinea pedis[J].Cutis,2006,78(4):268-274.
[15] Borelli C,Korting HC,B deker RH,et al.Safety and efficacy of sertaconazole nitrate cream 2% in the treatment of tinea pedis interdigitalis:a subgroup analysis.Cutis,2010,85(2):107-111.
[16] 刘静,张守民.硝酸舍他康唑乳膏治疗股癣42例疗效观察[J].中国皮肤性病学杂志,2012,26(8):762-763.
[17] Shivamurthy RP,Reddy SG,Kallappa R,et al.Comparison of topical anti-fungal agents sertaconazole and clotrimazole in the treatment of tinea corporis-An observational study[J].J Clin Diagn Res,2014,8(9):HC09-12.
[18] Choudhary S,Bisati S,Singh A,et al.Efficacy and safety of terbinafine hydrochloride 1% cream vs.sertaconazole nitrate 2% cream in tinea corporis and tinea cruris:A comparative therapeutic trial[J].Indian J Dermatol,2013,58(6):457.
[19] Jerajani HR,Janaki C,Kumar S,et al.Comparative assessment of the efficacy and safety of sertaconazole (2%) cream versus terbinafine cream (1%) versus luliconazole (1%) cream in patients with dermatophytoses:a pilot study[J].Indian J Dermatol,2013,58(1):34.
[20] 岳喜昂,刘卫兵,陈洪晓,等.硝酸舍他康唑乳膏每日1次疗法治疗股癣疗效观察[J].中国真菌学杂志,2012,7(3):170-172.
[21] Weinberg JM,Koestenblatt EK.Treatment of interdigital tinea pedis:once-daily therapy with sertaconazole nitrate[J].J Drugs Dermatol,2011,10(10):1135-1140.
[22] Wang PH,Chao HT,Chen CL,et al.Single-dose sertaconazole vaginal tablet treatment of vulvovaginal candidiasis[J].J Chin Med Assoc,2006,69(6):259-263.
[23] 吴启富.硝酸舍他康唑乳膏治疗儿童皮肤念珠菌病50例[J].中国真菌学杂志,2012,7(2):106-108.
[24] Bonifaz A,Tirado-Sánchez A,Graniel MJ,et al.The efficacy and safety of sertaconazole cream (2%) in diaper dermatitis candidiasis[J].Mycopathologia,2013,175(3-4):249-254.
[25] Goldust M,Rezaee E,Masoudnia S,et al.Clinical study of sertaconazole 2% cream vs.hydrocortisone 1% cream in the treatment of seborrheic dermatitis[J].Ann Parasitol,2012,59(3):119-123.
[26] Lotti T,Goldust M,Rezaee E.Treatment of seborrheic dermatitis,comparison of sertaconazole 2% cream versus ketoconazole 2% cream[J].J Dermatolog Treat,2013,May 6:[Epub ahead of print].
[27] Goldust M,Rezaee E,Rouhani S.Double blind study of sertaconazole 2% cream vs.clotrimazole 1% cream in treatment of seborrheic dermatitis[J].Ann Parasitol,2013,59(1):25-29.
[28] Goldust M,Rezaee E,Raghifar R,et al.Treatment of seborrheic dermatitis:The efficiency of sertaconazole 2% cream vs.tacrolimus 0.03% cream[J].Ann Parasitol,2013,59(2):73-77.
[29] Goldust M,Rezaee E,Raghifar R.Treatment of seborrheic dermatitis:comparison of sertaconazole 2% cream versus pimecrolimus 1% cream[J].Ir J Med Sci,2013,182(4):703-706.
[30] Goldust M,Rezaee E,Raghifar R.A double blind study of the effectiveness of sertaconazole 2% cream vs.metronidazole 1% gel in the treatment of seborrheic dermatitis[J].Ann Parasitol,2012,59(4):173-177.
[31] Saki N,Jowkar F,Alyaseen S.Comparison of sertaconazole 2% cream versus hydrocortisone 1% ointment in the treatment of atopic dermatitis[J].J Dermatolog Treat,2013,24(6):447-449.
[32] Weinberg JM.Increasing patient adherence in antifungal infection treatment:once-daily dosing of sertaconazole[J].J Clin Aesthet Dermatol,2009,2(2):38-42.