{"id":3504,"count":43,"description":"Pl\u00eds\u0148ov\u00e9 infekce postihuj\u00ed p\u0159ibli\u017en\u011b jednoho ze \u010dty\u0159 dosp\u011bl\u00fdch v ur\u010dit\u00e9m okam\u017eiku \u2014 nej\u010dast\u011bji k\u016f\u017ei (tinea pedis, tinea cruris, tinea corporis), nehty (onychomyk\u00f3za), poko\u017eku hlavy (tinea capitis), or\u00e1ln\u00ed nebo vagin\u00e1ln\u00ed kandid\u00f3zu a seboroickou dermatitidu. Z\u00e1va\u017en\u00e9 syst\u00e9mov\u00e9 pl\u00eds\u0148ov\u00e9 infekce (invazivn\u00ed kandid\u00f3za, aspergil\u00f3za, mukormyk\u00f3za) vy\u017eaduj\u00ed nemocni\u010dn\u00ed intraven\u00f3zn\u00ed l\u00e9\u010diva a nejsou sou\u010d\u00e1st\u00ed tohoto katalogu. Katalog l\u00e9\u010dby pl\u00eds\u0148ov\u00fdch infekc\u00ed MedsBase obsahuje 31 produkt\u016f<\/strong> pokr\u00fdvaj\u00edc\u00ed cel\u00e9 spektrum topick\u00fdch a peror\u00e1ln\u00edch antimykotik, dod\u00e1van\u00fdch spole\u010dnost\u00ed WHO-GMP certifikovan\u00fdch v\u00fdrobc\u016f<\/strong>.\n\nM\u00edstn\u00ed azoly.<\/strong> Topick\u00e9 azoly inhibuj\u00ed CYP51-mediovanou synt\u00e9zu ergosterolu u hub. Ketokonazol 2% kr\u00e9m a \u0161ampon (hlavn\u00ed prost\u0159edek pro seboroickou dermatitidu, pityriasis versicolor a povrchovou kandid\u00f3zu) je k dispozici jako Keto kr\u00e9m<\/a>, KZ kr\u00e9m<\/a>, Ketoforce<\/a>, a Keto ml\u00e9ko<\/a>. Mikonazol 2% kr\u00e9m a gel (\u0161irokospektr\u00e1ln\u00ed, zvl\u00e1\u0161t\u011b \u00fa\u010dinn\u00fd proti kandid\u00f3ze) je skladem jako Daktarin Gel<\/a> a Micogel<\/a>. Lulikonazol 1% (v\u00fdhoda jednodenn\u00ed aplikace) je k dispozici jako Lulibet XL kr\u00e9m<\/a>. Klotrimazol (vagin\u00e1ln\u00ed \u010d\u00edpky + kr\u00e9m) pro vulvovagin\u00e1ln\u00ed kandid\u00f3zu je skladem jako Candid V Gel<\/a>.\n\nAllylaminy (topick\u00e9 a peror\u00e1ln\u00ed).<\/strong> Terbinafin inhibuje squalen epoxid\u00e1zu a je fungicidn\u00ed proti dermatofyt\u016fm \u2014 prvn\u00ed volba u tinea pedis, tinea corporis, tinea cruris a onychomyk\u00f3zy. Topick\u00fd 1% kr\u00e9m je k dispozici jako Terbicip kr\u00e9m<\/a> a Terbiface<\/a>. Peror\u00e1ln\u00ed tablety 250 mg (zlat\u00fd standard pro onychomyk\u00f3zu: 6 t\u00fddn\u016f pro nehty na rukou, 12 t\u00fddn\u016f pro nehty na nohou) jsou skladem jako Terbicip<\/a>, Terbijohn<\/a>, Zimig<\/a>, a topick\u00fd Fintop Cream<\/a>. Peror\u00e1ln\u00ed terbinafin vy\u017eaduje v\u00fdchoz\u00ed vy\u0161et\u0159en\u00ed jatern\u00edch funkc\u00ed a kontrolu za 4\u20136 t\u00fddn\u016f \u2014 hepatotoxicita je vz\u00e1cn\u00e1, ale re\u00e1ln\u00e1. Vyhn\u011bte se u aktivn\u00edho jatern\u00edho onemocn\u011bn\u00ed.\n\nOr\u00e1ln\u00ed azoly.<\/strong> Flukonazol (ve vod\u011b rozpustn\u00fd, v\u00fdborn\u00e1 penetrace do mozkom\u00ed\u0161n\u00edho moku a mo\u010di, mo\u017enost t\u00fddenn\u00edho d\u00e1vkov\u00e1n\u00ed pro profylaxi chronick\u00e9 kandid\u00f3zy) je k dispozici jako Fluconaz<\/a>, \u2705 Rychl\u00e1 \u00faleva od p\u0159\u00edznak\u016f<\/a>, Zocon<\/a>, Zocon DT<\/a>, Fluka<\/a>, a Fluka Tobolka<\/a>. Jednor\u00e1zov\u00e1 d\u00e1vka 150 mg pro nekomplikovanou vulvovagin\u00e1ln\u00ed kandid\u00f3zu; t\u00fddenn\u00ed d\u00e1vka 150 mg pro recidivuj\u00edc\u00ed VVC; 6\u201312 t\u00fddn\u016f pro tinea pedis\/cruris. Itrakonazol (\u0161ir\u0161\u00ed spektrum v\u010detn\u011b dermatofyt\u016f, dimorfn\u00edch hub a mnoha pl\u00edsn\u00ed) je k dispozici jako Sporanox<\/a>, Itratuf<\/a>, Itrotab<\/a>, a Itaspor<\/a>. Pulzn\u00ed d\u00e1vkov\u00e1n\u00ed itrakonazolu (200 mg 2\u00d7 denn\u011b po dobu 1 t\u00fddne m\u011bs\u00ed\u010dn\u011b, 2 pulzy pro nehty na rukou, 3 pro nehty na nohou) je alternativn\u00ed re\u017eim pro onychomyk\u00f3zu, kdy\u017e je terbinafin kontraindikov\u00e1n. Vorikonazol (specializovan\u00fd prost\u0159edek pro invazivn\u00ed aspergil\u00f3zu) je skladem jako Voritrol<\/a> a Vorier.\n\nGriseofulvin.<\/strong> Klasick\u00fd peror\u00e1ln\u00ed antimykotikum st\u00e1le pou\u017e\u00edvan\u00e9 u tinea capitis u d\u011bt\u00ed (kde jsou azoly druhou volbou) a u t\u011b\u017ek\u00fdch rozs\u00e1hl\u00fdch tinea infekc\u00ed. K dispozici jako Grisovin FP<\/a>, Griso<\/a>, Grisoheal<\/a>, a Griseofulvin<\/a>. U\u017e\u00edvejte s tu\u010dn\u00fdm j\u00eddlem pro lep\u0161\u00ed vst\u0159eb\u00e1v\u00e1n\u00ed; l\u00e9\u010debn\u00e9 k\u00fary jsou dlouh\u00e9 (4\u20138 t\u00fddn\u016f u tinea capitis, a\u017e 12 m\u011bs\u00edc\u016f u onychomyk\u00f3zy). M\u00e9n\u011b \u010dasto pou\u017e\u00edv\u00e1n kv\u016fli pomalej\u0161\u00edmu \u00fa\u010dinku na houby ve srovn\u00e1n\u00ed s terbinafinem.\n\nTop\u00e1ln\u00ed laky na nehty.<\/strong> Amorolfin 5% lak (t\u00fddenn\u00ed aplikace) je k dispozici jako Loceryl l\u00e9k na nehty<\/a> a Nailrox Nail Lacquer<\/a>. Nejvhodn\u011bj\u0161\u00ed pro \u010dasn\u00e9 st\u00e1dium onychomyk\u00f3zy postihuj\u00edc\u00ed <50% nehtu s neporu\u0161enou matrix, nebo jako dopln\u011bk k peror\u00e1ln\u00edmu terbinafinu.\n\nKombina\u010dn\u00ed sady.<\/strong> Zocon-T Kit (fluconazol + tinidazol + adapalen-klindamycin \/ varianta s azithromycinem; pou\u017e\u00edv\u00e1 se pro kombinovan\u00e9 vagin\u00e1ln\u00ed\/cervik\u00e1ln\u00ed infekce) je dostupn\u00fd jako Zocon-T Kit<\/a>. Co-Trimoxazol je skladov\u00e1n jako Co-Trimoxazol<\/a> pro vybranou profylaxi pneumocyst\u00f3zy.\n\nJak vybrat.<\/strong> Lokalizovan\u00e9 povrchov\u00e9 tinea nebo kandid\u00f3za \u2192 lok\u00e1ln\u00ed azol nebo terbinafin po dobu 2\u20134 t\u00fddn\u016f. Rozs\u00e1hl\u00e9, recidivuj\u00edc\u00ed nebo posti\u017een\u00ed vlasov\u00e9 poko\u017eky\/neht\u016f \u2192 peror\u00e1ln\u00ed terbinafin jako prvn\u00ed volba u dermatofyt\u016f, peror\u00e1ln\u00ed flukonazol u kandidy a pityriasis versicolor, peror\u00e1ln\u00ed itrakonazol jako alternativa nebo pro \u0161ir\u0161\u00ed spektrum \u00fa\u010dinku. Vulvovagin\u00e1ln\u00ed kandid\u00f3za (nekomplikovan\u00e1) \u2192 flukonazol 150 mg v jedn\u00e9 d\u00e1vce nebo lok\u00e1ln\u00ed klotrimazol. Recidivuj\u00edc\u00ed VVC \u2192 flukonazol 150 mg t\u00fddn\u011b po dobu 6 m\u011bs\u00edc\u016f. T\u011b\u017ek\u00e9 invazivn\u00ed onemocn\u011bn\u00ed se \u0159e\u0161\u00ed v nemocnici.\n\nD\u016fle\u017eit\u00e9.<\/strong> P\u0159ed zah\u00e1jen\u00edm dlouhodob\u00e9 syst\u00e9mov\u00e9 terapie potvr\u010fte pl\u00eds\u0148ovou etiologii \u2014 mnoho \"tvrdohlav\u00fdch vyr\u00e1\u017eek\" je ekz\u00e9m nebo psori\u00e1za, nikoli pl\u00edse\u0148, a na antifung\u00e1ln\u00ed l\u00e9\u010dbu reaguj\u00ed h\u016f\u0159e ne\u017e na topick\u00e9 steroidy. P\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed peror\u00e1ln\u00edho terbinafinu a azol\u016f je nutn\u00fd monitoring jatern\u00edch funkc\u00ed. Itrakonazol a ketokonazol maj\u00ed v\u00fdznamn\u00e9 interakce s CYP3A4 (vyvarujte se kombinace se statiny, peror\u00e1ln\u00edm midazolamem, alkaloidy n\u00e1melu a mnoha inhibitory tyrosinkin\u00e1z). T\u011bhotn\u00e9 \u017eeny by nem\u011bly u\u017e\u00edvat \u017e\u00e1dn\u00e9 peror\u00e1ln\u00ed antifung\u00e1ln\u00ed l\u00e9ky bez odborn\u00e9ho doporu\u010den\u00ed.\n\nV\u0161echny p\u0159\u00edpravky na pl\u00eds\u0148ov\u00e9 infekce od MedsBase jsou odes\u00edl\u00e1ny z WHO-GMP certifikovan\u00fdch v\u00fdrobc\u016f<\/strong> s diskr\u00e9tn\u00edm celosv\u011btov\u00fdm doru\u010den\u00edm a jsou chr\u00e1n\u011bny na\u0161\u00edm Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/a>.","link":"https:\/\/medsbase.com\/cs\/fungal-infection-treatment\/","name":"L\u00e9\u010dba pl\u00eds\u0148ov\u00fdch infekc\u00ed","slug":"fungal-infection-treatment","taxonomy":"product_cat","parent":3342,"meta":[],"menu_order":0,"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/3504","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/taxonomies\/product_cat"}],"up":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat\/3342"}],"wp:post_type":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product?product_cat=3504"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}