From the Research
For severe fungal intertrigo, fluconazole is typically prescribed at a dose of 150-200 mg orally once daily for 7-14 days, as supported by the most recent and highest quality study available 1.
Treatment Overview
The treatment of severe fungal intertrigo with fluconazole involves oral administration, with the option to extend treatment to 2-4 weeks in severe cases or if the infection is slow to respond.
- The initial loading dose may be twice the daily dose (300-400 mg) on the first day to achieve therapeutic levels more quickly.
- Fluconazole works by inhibiting fungal cytochrome P450-dependent enzymes, preventing the synthesis of ergosterol, an essential component of fungal cell membranes.
- This leads to increased cell permeability and ultimately cell death.
Administration and Precautions
- Patients should take the medication with or without food at approximately the same time each day.
- Dose adjustments may be necessary for patients with renal impairment, as fluconazole is primarily eliminated unchanged in the urine 2.
- Common side effects include nausea, headache, and abdominal pain.
- Patients should be advised to complete the full course of treatment even if symptoms improve before completion to prevent recurrence and development of resistance.
Concurrent Treatment
- Concurrent topical antifungal treatment may also be beneficial to accelerate symptom relief.
- The choice of concurrent treatment should be based on the specific fungal infection and the patient's overall health status.
Evidence Summary
The recommended dosing regimen is based on the study by 1, which reviewed the effectiveness of oral antifungal agents, including fluconazole, in the treatment of common superficial fungal infections of the skin.