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Not enough good quality trials to assess the most effective drug treatment for paracoccidioidomycosis

Paracoccidioidomycosis is a fungal infection that causes ulcers, swelling, fever, and pain. If it also gets into the lungs, it can produce coughing, shortage of breath, chest pain, weight loss, and sometimes death. Without treatment, those suffering this disease may die in a few months or years. There are endemic areas between Mexico and southern Argentina. Drug treatments need to go on for many months and maybe years. There are various drugs that are used, but this review found only two small trials with too few data to say which drug was best, and the drugs all seem to have adverse effects. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Antifungal drugs (azoles) for allergic bronchopulmonary aspergillosis associated with asthma

Allergic bronchopulmonary aspergillosis is a condition that complicates some people with chronic asthma. Standard treatment for this condition is high doses of oral steroids. The azole antifungal drugs attack the fungus that causes this condition and short term studies suggest that they may have some benefit when added to standard therapy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

What treatments are available for tinea versicolor?

Tinea versicolor can usually be effectively treated using topical (externally applied) medications. These contain a substance that keeps the fungus from growing or kills it. Even with treatment, it can take several months for the skin to return to normal.Tinea versicolor is a skin condition that affects about 1% of the population in countries with a moderate climate. The main symptom is discolored (lighter or darker) patches of skin, mostly on the upper body. It is caused by a type of fungus that is found on most people’s skin. Tinea versicolor is not contagious.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 1, 2017

The prevention and treatment of oral thrush

If someone is at higher risk of developing oral thrush, it is a good idea to try to take preventive measures. Aside from various forms of oral hygiene, antimycotics (antifungal drugs) can be used to prevent oral thrush. These medications can also be used to treat this infection.Oral thrush, also known as candidiasis, is a fungal infection in the mouth and throat area. It is caused by types of yeast fungus called Candida that grow on the mucous membranes lining the mouth and throat. Many people have a small amount of this kind of fungus on their mucous membranes without having any noticeable problems. But given the right conditions, the yeast fungus can start reproducing very quickly. The infection appears as a white coating and red inflamed areas in the mouth and throat region. It is sometimes painful and can impair your sense of taste, as well as making it difficult to speak or eat.The risk of oral thrush is higher in people who have a weakened immune system, for instance due to a chronic disease or an intensive treatment such as chemotherapy. It is also common in people who have HIV/AIDS, and is often quite distressing. Some end up eating very little because of the pain in their mouth and throat, which can make their body even weaker.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 18, 2016

Antiglucocorticoid and related treatments for psychosis

Psychosis is a broad term that includes several mental illnesses such as schizophrenia, schizophreniform disorder, schizoaffective disorder, psychotic depression and bipolar disorder with psychotic features. Psychotic disorders affect about 3% of the population and may cause high levels of disability, making it a significant public health problem both socially and economically.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Antifungal medicines for treating children with ringworm

Tinea capitis, or ringworm, is a fungal infection of the scalp caused mainly by two species of fungi called Trichophyton and Microsporum. It is common in children. Most fungal infections can be treated with antifungal creams applied directly to the skin (topical treatments). However, because the fungal infection is found at the root of the hair follicles, where topical treatments cannot reach, tinea capitis always requires medication administered by mouth so that the treatment spreads throughout the entire body (systemic treatments). There are several different types of antifungal medicines available.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Antifungal treatments applied to the skin to treat seborrhoeic dermatitis

Seborrhoeic dermatitis is a chronic inflammatory skin condition found throughout the world, with rashes with varying degrees of redness, scaling and itching. It affects people of both sexes but is more common among men. The disease usually starts after puberty and can lead to personal discomfort and cosmetic concerns when rashes occur at prominent skin sites. Drugs that act against moulds, also called antifungal agents, have been commonly used on their own or in combination.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Prevention of fungal infections in patients with cancer with antifungal drugs

Cancer patients receiving chemotherapy or a bone marrow transplant are at risk of fungal infections. These can be life‐threatening, especially when they spread throughout the body. Those patients with low white cell counts (neutropenia) are particularly at risk. Antifungal drugs are often given as a routine preventive measure, or when people who are at risk have a fever. The review found that intravenous amphotericin B could reduce the number of deaths. Three of the drugs, amphotericin B, fluconazole and itraconazole, reduced fungal infections.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Interventions for the prevention and management of oral thrush associated with HIV infection in adults and children

Oral candidiasis (thrush) associated with human immunodeficiency virus (HIV) infection occurs commonly and recurs frequently, often presenting as an initial manifestation of the disease. Interventions aimed at preventing and treating HIV‐associated oral thrush form an integral component of maintaining the quality of life for affected individuals. This review evaluated the effects of interventions in preventing or treating oral thrush in children and adults with HIV infection. Thirty three trials (n=3445) were included. Twenty two trials investigated treatment and eleven trials investigate prevention. There was no difference with regard to clinical cure between fluconazole compared to ketoconazole, itraconazole, clotrimazole and posaconazole. Fluconazole, gentian violet and ketoconazole were superior to nystatin. Compared to placebo and no treatment, fluconazole was effective in preventing clinical episodes from occurring. Continuous fluconazole was better than intermittent treatment. Insufficient evidence was found to come to any conclusion about the effectiveness of clotrimazole, nystatin, amphotericin B, itraconazole, ketoconazole or chlorhexidine with regard to OC prophylaxis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Oral antifungal drugs for treating athlete's foot (tinea pedis)

Athlete's foot (tinea pedis) is a fungal infection of the feet that is easily spread and difficult to get rid of. This review compared different oral antifungal drugs (i.e. drugs taken by mouth), and it included 15 trials, involving 1438 participants. There are several different kinds of oral treatments, and the trials we found considered all the oral drugs used to treat athlete's foot. We found terbinafine and itraconazole to be more effective than placebo. And we found terbinafine to be more effective than griseofulvin. Griseofulvin is a treatment that was developed much earlier than the new treatments, such as terbinafine and itraconazole; these newer treatments tend to be most evaluated. Trials of other drugs were not large enough to show differences between them. All drugs had side‐effects; gastrointestinal effects were the most common.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Antifungal agents for preventing fungal infections in critically ill adults and children with a normal number of neutrophils in the blood

We reviewed the evidence about the effect of giving antifungal medications before a definitive diagnosis of fungal infections on mortality from all causes and development of severe infections due to fungi (invasive fungal infections) in adults and children who are critically ill but non‐neutropenic, i.e. with a normal number of neutrophils in their blood.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Antifungal drugs used for prevention can significantly reduce the number of invasive fungal infections in liver transplant patients

Invasive fungal infections ‐ infections of the bloodstream and organs within the body (e.g. meningitis, pneumonia, peritonitis) ‐ are important causes of morbidity and mortality in liver, pancreas, heart, kidney and lung (i.e. solid organ) transplant recipients. This review found that fluconazole, used as a preventive drug, significantly reduced the number of invasive fungal infections in liver transplant patients. More studies are needed to determine how effective antifungal drugs are for pancreas, heart, kidney and lung transplant patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Interventions for American cutaneous and mucocutaneous leishmaniasis.

American cutaneous and mucocutaneous leishmaniasis, a disfiguring and stigmatising disease affecting Central and South American regions, is caused by a parasite transmitted by sandflies. Pentavalent antimonial drugs (sodium stibogluconate (Pentostam, Stibanate, SSG) and meglumine antimoniate (Glucantime, MA)) have been used since the 1940s as first‐line therapeutic agents for cutaneous leishmaniasis worldwide. However, other treatments have been used because these are expensive, toxic and painful, and because resistance is emerging.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Tinea versicolor: Overview

If a fungus grows a lot it may lead to a medical condition. Tinea versicolor is one example. This skin condition is caused by a fungus, and is usually harmless. Many people who have it don’t know that a fungus is to blame for their discolored skin patches. Read about the typical symptoms and effective treatments.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 1, 2017

Cyproterone acetate appears to be as effective as other medications for hirsutism in women caused by excessive androgen production by the ovaries

One of the causes of hirsutism (excessive hair growth) in women is excessive production of the hormone androgens by the ovaries. A variety of medications can be used to counter the effects of the androgen. Cyproterone acetate is an anti‐androgen drug. Adverse effects that have been reported with its use include weight gain, depression, fatigue, breast symptoms and sexual dysfunction. The review of trials found that cyproterone acetate appears to have a similar impact on hirsutism as other drugs used for hirsutism caused by excessive androgen. There was not enough evidence to compare adverse effects of the treatment options.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Interventions for treating oral candidiasis for patients with cancer receiving treatment

Cancer treatment can lead to severe fungal infections (candidiasis, called thrush) in the mouth. This can cause pain, difficulties in eating and longer hospital stays. Infection can sometimes spread through the body and become life‐threatening. Different drugs are used to try and relieve candidiasis. There is insufficient evidence that any of the antifungal drugs may cure fungal infections in the mouth for people with cancer and more research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Topical anti‐inflammatory agents for seborrhoeic dermatitis of the face or scalp

Seborrhoeic dermatitis is an inflammation of the skin that most often affects areas of the body that have a lot of sebaceous glands. These include the skin of the scalp; face; chest; and flexure areas such as the armpits, groin, and abdominal folds. The most typical symptoms of seborrhoeic dermatitis are scaling of the skin and reddish patches. Seborrhoeic dermatitis is fairly common: one to three in 100 people have seborrhoeic dermatitis. The disease is more common in men than in women. Anti‐inflammatory, antifungal, and antikeratolytic treatments can be used to treat seborrhoeic dermatitis. The treatment does not cure the disease but relieves the symptoms.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Clomiphene and other antioestrogens for subfertility associated with anovulation

Subfertility due to the absence of ovulation is a common problem in women. Medical treatment may help these women ovulate. For example, oral antioestrogens such as clomiphene cause increased stimulation of the ovaries and aid ovulation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Prostate Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of prostate cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: July 7, 2016

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