Hydroxy-Pyridones as Antifungal Agents with Special Emphasis on Onychomycosis

This book presents a series of papers on a special group of antifungal agents - the hydroxypyridones (e.g. Ciclopirox, Rilopirox, and Piroctone) given by international experts at conferences in Vancouver and Sydney. The action of this group of agents is unique. Hydroxypyridones are not only active against all relevant fungi, but they are active against dermato- phytes, yeasts, moulds as well as gram positive and gram negative bacteria. They have an inhibitory effect on the lipoxygenase and cyclo-oxygenase path- ways and, in vitro, exhibit fungicidal and even sporicidal activity. Ciclopirox is particularly able to penetrate keratin. These properties facilitate the treatment not only of tinea pedis caused by fungi but also of infections by gram negative bacteria. The special ability of Ciclopirox to penetrate keratin opens the door to an efficacious topical treat- ment for onychomycosis, with a transungual drug delivery system specially adapted to infections of the nail organ. The absence of drug interactions and systemic side effects of this formulation is an appreciable advantage over the newer systemic therapies for onychomycosis. Papers are presented covering the mode of action, antimicrobial spectrum, pharmacological properties, penetration potential, clinical efficacy and the various indications for this group of drugs. They will enable the reader to as- sess the advantage and disadvantage of this new therapeutic modality.