Introduction
Treatment of fungal infection may include:
- General measures
- Reducing reinfection
- Topical antifungal medication
- Oral antifungal medication
- Antifungal drug resistance.
General measures
- Correct predisposing factors where possible.
- Keep the affected skin clean and dry. Wash daily. Take care to dry between the toes and in the skin folds; use a hair dryer if necessary. Use your own towel.
- Carefully clean the shower or bath using bleach.
- Hot wash socks, towels, bathmats at a temperature of at least 60°C.
- Regularly wash floors where you walk bare foot.
- Use an antiseptic
- Dequalinium chloride lozenges for oral candidiasis (Dequacaine®, Dequadin®)
- Di-iodohydroxyquinoline for vulvovaginal candidiasis (Floraquin® vaginal tablets).
To reduce reinfection
Fungal spores can survive long periods. The following measures can be used to reduce the chance of reinfection.
- Do not share towels, sheets or personal clothing.
- Avoid walking bare foot where others may tread - wear jandals, sandals or aquasocks at the public pools and sports changing rooms.
- Avoid long periods wearing the same clothing, or wearing occlusive clothing such as wet weather gear and nylon pantyhose.
- Wear open-toed sandals when possible. Avoid long periods in occlusive footwear such as gum boots or tramping boots.
- Use antifungal foot powder containing ciclopirox, econazole, miconazole, tolciclate, tolnaftate or undecylenic acid. Sprinkle it in your shoes.
- In the case of zoophilic fungal infections, infected animals should be identified and treated.
Antifungal drug resistance
In recent years, both topical and oral allylamine and triazole antifungal drug resistance has become a problem, particularly in the Indian subcontinent.
Extensive therapy-resistant dermatophyte infection should prompt this as a possible problem. Where available, fungal culture and estimation of drug minimum inhibitory concentration determined to guide appropriate medication
For more information, see antifungal drug resistance
We suggest you refer to your national drug approval agency such as the Australian Therapeutic Goods Administration (TGA), US Food and Drug Administration (FDA), UK Medicines and Healthcare products regulatory agency (MHRA) / emc, and NZ Medsafe, or a national or state-approved formulary eg, the New Zealand Formulary (NZF) and New Zealand Formulary for Children (NZFC) and the British National Formulary (BNF) and British National Formulary for Children (BNFC).