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Changing scenario of superficial fungal infection: Emerging resistance, recurrence and remedy in Bangladesh

机译:浅析浅析性感感染的情景:孟加拉国的新兴抵抗,复发和补救措施

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Superficial fungal infections (dermatophytes) affecting skin, nail and hair are the most common infective dermatosis seen in dermatology outpatient clinics. There is a rising prevalence of dermatophytosis, especially in tropical countries like Bangladesh, with a concomitant increase in the number of difficult to treat cases. The reason for this phenomenon is not yet clear, but may be related to inadequate treatment regimen or discontinuation of medication, difficulties in eliminating predisposing factors and sources of re-infection. The pathogenesis and severity of fungal infection depend on various immunological and nonimmunological factors. The rampant use of antifungal therapy in immunocompromised individuals marked the onset of antifungal drug resistance. Fungal resistance can be microbiological or clinical. Genetic alterations in the fungi cause microbiological resistance. Clinical resistance is due to host or drug related factors. All these factors may cause fungal resistance individually or in tandem. Appropriate drug dosing along with antifungal drug susceptibility testing, especially for the dermatophytes isolated from chronic, recurrent cases or those with atypical presentation should be encouraged. Other ways to avoid resistance is the use of combination antifungal therapy. Combination therapy offers advantages in increased synergistic action with enhanced spectrum activity. Finally, newer insights into molecular mechanisms of drug resistance will help in the development of appropriate antifungal therapy. Till then experience based treatment of dermatophytosis is more effective than the standard guideline.
机译:影响皮肤,钉子和头发的浅表性真菌感染(Dermatophytes)是皮肤科门诊诊所中最常见的感染皮肤病。皮肤病患病率升高,特别是在孟加拉国等热带国家,伴随着治疗案件的难度增加。这种现象的原因尚不清楚,但可能与治疗方案不足或中断药物,消除易受诱惑因素和重新感染来源的困难。真菌感染的发病机制和严重程度依赖于各种免疫学和非家庭因素。抗生素治疗猖獗在免疫抑制个体中使用抗真菌耐药性的发病。真菌抗性可以是微生物或临床的。真菌的遗传改变引起微生物抗性。临床抵抗是由于宿主或毒品相关因素。所有这些因素可能会单独或串联造成真菌抗性。应鼓励适当药物给药以及抗真菌药物易感性测试,特别是对于从慢性,经常性病例或具有非典型呈现的皮肤病的皮肤病药物。其他避免抵抗的方法是使用组合抗真菌治疗。联合疗法在增强的频谱活动方面提高了协同作用的优势。最后,进入耐药性分子机制的新见解将有助于开发适当的抗真菌治疗。直到那时基于体验的皮肤病治疗比标准指南更有效。

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