پاسخ كچلي سر به داروهاي ضد قارچي در يك مدل In vitro

Antifungal Drug Effect against an In Vitro Model of Tinea capitis

Background and objective: Tinea capitis is one of the dermatophytosis which could involve skin, hair, eyebrow and eyelash. In the lack of proper treatment, it will change to a chronic disease. The main objective of this study is determination of drug-resistance of fungi causing Tinea capitis by introducing new method of antibiogram, evaluating of antifungal drugs in an in vitro model and application of fungal antibiogram like bacteria and decrease the treatmentʹs costs. Material and method: In this study, the susceptibility of 8 strains belonging to 5 species of dermatophytes to 4 antifungal drugs including Terbinafine, Geriseofulvin, floconazole and ketoconazole have been carried out by Broth Macrodilution method according to NCCLS protocols. The susceptibility of strains have determined in two stages: without and with the presence of childrenʹs hair (very small pieces of hair), respectively. Results: In the first phase terbinafine was the most effective drug against most of species, and Trichophton mentagrophytes was the sensivitiest fungi. Fluconazole had the lowest effect on all strains. Trichophyton rubrum and Trichophton mentagrophytes had the highest MIC and Trichophyton schoenleinii had the lowest MIC of ketoconazole. About griseofulvin, Microsporum gypseum and Trichophyton schoenleinii showed the highest and the lowest MIC, respectively. In the second phase MIC of drugs with presence of small pieces of hairs were increased for most stains. Data statistical analysis about all used fungi and drugs showed a meaningful difference between MIC of drugs obtained from two studied phase (p=0.0001). Conclusion: This study showed the most effectiveness of terbinafine against numerous strains. However, because of various reasons such as tolerability of patients, costs of treatment... griseofulvin is the selective drug for treatment of Tinea capitis infections. In this research small pieces of hairs were used for creating in vivo similar condition to evaluate the effect of drugs on the infection. The results showed meaningful increasing in MICs and more resistance of fungi to studied drugs in presence of hairs. Due to little information about antifungal drugs in Iran, results of this study showed that it is necessary to focus on reinforcement of measures for infection control and design of strategies to more effective treatment of patients.