From the Guidelines
Canestan, containing clotrimazole, is a suitable treatment option for mild fungal infections, but its use should be guided by the severity of the infection and the specific type of fungus involved, as recommended by the most recent guidelines 1.
Treatment Options
- For mild disease, clotrimazole troches, 10 mg 5 times daily, or miconazole mucoadhesive buccal 50-mg tablet applied to the mucosal surface over the canine fossa once daily for 7–14 days are recommended 1.
- For moderate to severe disease, oral fluconazole, 100–200 mg daily, for 7–14 days is recommended 1.
- For fluconazole-refractory disease, itraconazole solution, 200 mg once daily, or posaconazole suspension, 400 mg twice daily for 3 days then 400 mg daily, for up to 28 days are recommended 1.
Important Considerations
- Chronic suppressive therapy is usually unnecessary, but if required, fluconazole, 100 mg 3 times weekly, is recommended 1.
- For HIV-infected patients, antiretroviral therapy is strongly recommended to reduce the incidence of recurrent infections 1.
- Pregnant women should consult a healthcare provider before using Canestan, as the safety of clotrimazole during pregnancy has not been well established 1.
Side Effects and Precautions
- Common side effects of Canestan may include mild burning, irritation, or itching at the application site 1.
- It's essential to complete the full course of treatment even if symptoms improve quickly to prevent recurrence 1.
- If symptoms persist after treatment or recur frequently, medical advice should be sought as this may indicate an underlying condition requiring different management 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Canestan Overview
- Canestan is a brand name for an antifungal medication, however the provided studies do not mention Canestan specifically.
- The studies focus on the treatment of superficial fungal infections, including tinea pedis (athlete's foot), using various oral and topical antifungal agents 2, 3, 4, 5, 6.
Treatment Options
- Topical antifungal therapy is the mainstay of treatment for superficial or localized tinea pedis, with examples of topical antifungal agents including allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate, and amorolfine 2.
- Oral antifungal therapy should be reserved for severe disease, failed topical antifungal therapy, concomitant presence of onychomycosis, or in immunocompromised patients 2, 3.
- Oral antifungal agents used for the treatment of tinea pedis include terbinafine, itraconazole, and fluconazole 2, 3, 4, 5, 6.
Efficacy of Treatment Options
- Terbinafine is more effective than griseofulvin in treating tinea pedis 4, 5.
- Terbinafine and itraconazole are more effective than no treatment in treating tinea pedis 4, 5.
- Fluconazole, itraconazole, and terbinafine are effective in treating various superficial fungal infections, including pityriasis versicolor, tinea corporis/cruris, and tinea pedis 6.