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Topical antifungal agents :allyamines & azoles prescribing guide

Managing fungal skin infections effectively is a common concern for primary care practitioners in the UK. Whether it's tinea infections like athlete's foot and jock itch or more complex issues like candidiasis, the choice of treatment often comes down to topical antifungals. This guide aims to provide an in-depth look at the two major classes of topical antifungal agents available in the UK: Allylamines and Azoles. We will discuss commonly used drugs in these categories, their key indications, available formulations, and typical duration of treatment. Please always refer to the BNF before prescribing and for specific instructions.


ClassDrug NameCommon IndicationsFormulationsTypical DurationComments & ConsiderationsReferences
AllylaminesTerbinafineTinea pedis, Tinea cruris, Tinea corporisCream, Gel, Spray1-4 weeksFirst-line for many dermatophyte infections. Rapid fungicidal action.NICE CKS, Fungal Skin Infection
AllylaminesNaftifineTinea pedis, Tinea crurisGel2-4 weeksLess commonly used. Potential for local irritation.NICE CKS, Fungal Skin Infection
AzolesClotrimazoleCandidiasis, Tinea infectionsCream, Solution2-4 weeksBroad spectrum but fungistatic.BNF 2021
AzolesMiconazoleCandidiasis, Tinea infectionsCream, Powder2-4 weeksAlso has some antibacterial properties.BNF 2021
AzolesKetoconazoleTinea infections, Seborrhoeic dermatitisCream, Gel2-4 weeksLimited by potential...

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