891 resultados para Antifungal agents
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Pós-graduação em Biologia Geral e Aplicada - IBB
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Pós-graduação em Biopatologia Bucal - ICT
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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BackgroundThere are no published reports on studies comparing itraconazole (ITC), sulfamethoxazole-trimethoprim (cotrimoxazole, CMX), and ITC followed by CMX (ITC/CMX) in the treatment of paracoccidiodomycosis. This study aimed to compare the efficacy, effectiveness, safety and time to clinical and serologic cure in paracoccidioidomycosis patients treated with ITC or CMX, the antifungal agents most widely used.MethodologyA quasi-experimental study was performed in 177 patients with a confirmed or probable diagnosis of paracoccidioidomycosis. Treatment was divided into two stages: 1) initial, which was continued until clinical cure was achieved and the erythrocyte sedimentation rate decreased to normal values; 2) complementary, which was continued until serologic cure was achieved. Medians were compared via the Mann-Whitney test, and frequencies were compared via the chi-squared test. The assessment of variables as a function of time was performed using Kaplan-Meier curves and Cox regression. The significance level was established as p <= 0.05.Principal FindingsNo difference was found in the efficacy and effectiveness of the initial treatment of 47 individuals given ITC and 130 individuals given CMX; however, the time to clinical cure was shorter in the former compared with the latter group (105 vs. 159 days; p = 0.001), specifically in patients with the chronic form. Efficacy and effectiveness of the three regimens were similar in the complementary treatment; however, the time to serologic cure was shorter when ITC (161 days) or CMX (495 days) was used compared with ITC/CMX (881 days) [p = 0.02]. The independent predictors of a shorter time to serologic cure were treatment with ITC [risk ratio = 6.61 (2.01-21.75)] or with CMX [risk ratio = 5.11 (1.91-13.67)]). The prevalence of side effects was lower with ITC (6.4%) than with CMX (20.0%; p = 0.03).ConclusionsSince ITC induced earlier clinical cure and was better tolerated than CMX, such triazole should be considered the first-choice for PCM treatment.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Fármacos com alta permeabilidade intestinal, ampla faixa terapêutica e ausência de evidências documentadas de bioinequivalência ou problemas de biodisponibilidade devido à formulação, foram considerados bioisentos pela ANVISA (RDC 37/2011), ou seja, os fármacos que se encaixam nesta categoria não necessitam de estudos de biodisponibilidade relativa/bioequivalência para serem comercializados. Dentre os catorze produtos que receberam a bioisenção da ANVISA, encontra-se o fluconazol, antifúngico aprovado atualmente para ser comercializado em vários países, inclusive no Brasil, onde inúmeras opções comerciais do produto fluconazol cápsulas, genérico ou similar, podem ser adquiridas. Tendo em vista a bioisenção do produto fluconazol cápsulas e sua larga utilização no mercado brasileiro, o estudo do perfil de dissolução deste produto torna-se relevante. Sendo assim, este trabalho avaliou 2 produtos genéricos e 2 produtos similares frente ao medicamento referência em relação aos seus perfis de dissolução e a similaridade entre eles. Os resultados foram avaliados seguindo a RDC 31/2011 da ANVISA que prevê o cálculo do fator de similaridade entre os perfis de dissolução. E, pôde-se observar que apenas 1 medicamento genérico apresentou o fator de similaridade adequado (entre 50 e 100), sendo 51,60, os demais medicamentos testes apresentaram valores fora do intervalo adotado pela ANVISA. Através desses resultados, conclui-se que intercambialidade do medicamento referência pelo medicamento genérico ou similar não é adequada, uma vez que eles não são considerados iguais, salvo um dos medicamentos genéricos.
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O fluconazol (FLU) é um antifúngico muito utilizado no tratamento de dermatomicoses devido à sua eficácia e segurança. No entanto, este pode apresentar perfil farmacocinético muitas vezes inadequado, promovendo recorrência da doença ou resistência do fungo, apresentando uma série de efeitos colaterais além de alta toxicidade. Por esta razão, há uma busca contínua de novos medicamentos antifúngicos mais potentes, mas, sobretudo, mais seguros que os existentes. Os carreadores lipídicos nanoestruturados (NLCs) são compostos por uma matriz contendo lipídio liquido e sólido, e possui como uma de suas vantagens a alta capacidade de encapsulamento. O objetivo do trabalho foi desenvolver e caracterizar NLCs para administração cutânea de fluconazol. A solubilidade do FLU foi avaliada em ácido oleico (AO) e monoestearato de glicerila (GMS) e observou-se uma maior incorporação de FLU na mistura desses lipídios do que nos compostos isolados. Os NLCs contendo AO, GMS, poloxamer-407, fosfatidilcolina de soja (PC) e FLU foram desenvolvidos empregando o método de homogeneização em alta velocidade de cisalhamento à quente. A caracterização foi realizada por espectroscopia de correlação de fótons e os resultados de diâmetro médio, índice de polidispersidade e potencial zeta foram de 218,63 e 314,1nm, 0,417 e 0,640 e -28,4 e -25,8mV para os NLCs com (NLC_FLU) e sem o FLU (NLC) respectivamente. No estudo de estabilidade, as formulações NLC e NLC_FLU foram armazenados à 8ºC e à temperatura ambiente e os resultados mostraram maior estabilidade durante os seis meses para os NLC_FLU armazenada à 8ºC. A morfologia dos NLCs foi determinada por microscopia eletrônica de varredura de efeito de campo na qual os NLCs apresentaram morfologia esférica e escala nanométrica. Uma metodologia foi validada por espectrofotometria na região do ultravioleta para a determinação da eficiência de encapsulação (EE) do fármaco que foi ...
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The objective of this study is to report the clinical use of 2% Uncaria tomentosa gel against denture stomatitis (DS) as an alternative treatment. The patient was a 65-year-old, denture-wearing woman. At the clinical examination, her palate showed hyperplasic and erythematous mucosa indicating DS type II. DS is a chronic oral disease that affects denture wearers. It occurs as an inflammatory reaction in denture-wearing patients under maxillary prostheses. Candida albicans has been reported as the principal etiological agent. An alternative treatment, the topical application of a gel of 2% U. tomentosa three times a day for 1 week was given to the patient. After 1 week of this treatment, she had significantly reduced signs of the disease. Despite the existence of a great number of antifungal agents, treatment failure is observed frequently. Phytotherapy is becoming more popular worldwide. Currently, the most promising medicinal Amazonian herb is U. tomentosa (Willd.) DC., known as Cat's Claw. Studies of the chemical and pharmacological properties of this medicinal plant have allowed researchers to develop indications for its use. This report demonstrates the effectiveness of U. tomentosa against DS.
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The aim of this study was to evaluate the antimicrobial activity of alcohol-free mouthwashes on Candida albicans. Twenty clinical isolates of C. albicans and one reference strain (ATCC 18804) were evaluated after exposure to two 0.12% chlorhexidine-based and alcohol-free (“Ca” and “Or”) in comparison to gluconate chlorhexidine with ethanol (positive control). The maximum inhibitory dilution (MID) and maximum fugal dilution (MFD) were determined by the microdilution method. Twelve serial dilutions (from 50 to 0.02%) were prepared in duplicate. Then, 100 µL of C. albicans suspension (106 cells.mL–1) were added to the wells. After incubation (37 °C/24 hours), MID was determined by reading the optical density. For MFD determination, the content of the wells were plated on Saouraud agar. For MID, there were no differences between groups Or and control, but Ca group showed a MID statistically higher (Kruskal-Wallis, p = 0.0012). For MFD, there were no differences between Ca and control (Mann-Whitney test, p = 0.1631). It can be concluded that Ca group showed a fungicid activity against C. albicans similar to the control, but lower fungistatic activity when compared to the control. Group Or showed only a fungistatic action similar to control.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Human fungal infections have increased at an alarming rate in recent years, particularly in immunocompromised individuals. Cryptococcosis is the second most prevalent systemic fungal infection worldwide, and the most prevalent systemic infection in immunocompromised individuals, representing more than 70% of cases. The incidence of cryptococcosis is high in people with HIV/acquired immunodeficiency syndrome (AIDS), with recent estimates indicating that there are one million cases of cryptococcal meningitis globally per year in AIDS patients. The aim of this research was to develop a rapid flow cytometric antifungal susceptibility test and to compare the results with the standard methods. A reference strain and clinical isolates of Cryptococcus neoformans and Cryptococcus gattii were tested for susceptibility to amphotericin B by flow cytometry using propidium iodide as indicator of viability. Flow cytometry (FC) results were compared with the minimum inhibitory concentration (MIC) values determined by microdilution. The antifungal activity of amphotericin B ranged from MICs of 0.06 to 2μg/ml for the 11 isolates studied. The same results were found by FC. The FC method allows same-day results, assisting in the selection of appropriate antifungal therapies. These results demonstrate an excellent correlation between FC and the classic methods of testing for susceptibility to antifungal agents. This rapid diagnosis method makes it possible to quickly administer effective therapeutic interventions, often saving lives.
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Background: Human fungal infections have increased at an alarming rate in recent years, particularly in immunocompromised individuals. Cryptococcosis is the second most prevalent systemic fungal infection worldwide, and the most prevalent systemic infection in immunocompromised individuals, representing more than 70% of cases. The incidence of cryptococcosis is high in people with HIV/acquired immunodefi- ciency syndrome (AIDS), with recent estimates indicating that there are one million cases of cryptococcal meningitis globally per year in AIDS patients. Aims: The aim of this research was to develop a rapid flow cytometric antifungal susceptibility test and to compare the results with the standard methods. Methods: A reference strain and clinical isolates of Cryptococcus neoformans and Cryptococcus gattii were tested for susceptibility to amphotericin B by flow cytometry using propidium iodide as indicator of viability. Flow cytometry (FC) results were compared with the minimum inhibitory concentration (MIC) values determined by microdilution. Results: The antifungal activity of amphotericin B ranged from MICs of 0.06 to 2 g/ml for the 11 isolates studied. The same results were found by FC. Conclusions: The FC method allows same-day results, assisting in the selection of appropriate antifungal therapies. These results demonstrate an excellent correlation between FC and the classic methods of testing for susceptibility to antifungal agents. This rapid diagnosis method makes it possible to quickly administer effective therapeutic interventions, often saving lives.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Biociências e Biotecnologia Aplicadas à Farmácia - FCFAR
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)