Butoconazole
Kelas obat: Agen Antineoplastik
Panganggone Butoconazole
Kandidiasis Vulvovaginal
Pengobatan kandidiasis vulvovaginal sing ora rumit (andheg nganti moderat, sporadis utawa jarang, paling kamungkinan disebabake Candida albicans, kedadeyan ing wanita immunocompetent). Obat pilihan.
Obat mandhiri (nggunakake OTC) kanggo perawatan kandidiasis vulvovaginal sing ora rumit ing wanita sing sehat lan ora ngandhut sing sadurunge wis didiagnosis dening dokter lan ngalami gejala sing padha.
Pengobatan kandidiasis vulvovaginal sing rumit, kalebu infeksi sing berulang (≥4 episode ing 1 taun), abot (eritema vulva ekstensif, edema, ekskoriasi, pembentukan fisura), sing disebabake dening Candida liyane saka C. albicans, utawa kedadeyan ing wanita kanthi kondisi medis sing ndasari (diabetes mellitus sing ora bisa dikontrol, infeksi HIV, terapi imunosupresif, meteng). Infeksi sing rumit umume mbutuhake perawatan sing luwih dawa tinimbang infeksi sing ora rumit.
Rejimen optimal kanggo perawatan kandidiasis vulvovaginal sing disebabake dening Candida liyane saka C. albicans (contone, C. glabrata, C. krusei) ora diidentifikasi. CDC lan liya-liyane nyatakake yen infeksi kasebut bisa nanggapi antijamur azole intravaginal sing diwenehake sajrone 7-14 dina utawa regimen 14 dina asam borat intravaginal (ora kasedhiya kanggo komersial ing AS).
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Carane nggunakake Butoconazole
Administrasi
Administrasi Topikal Intravaginal
Atur intravaginal minangka krim nggunakake aplikator sing wis diisi sadurunge sing diwenehake dening pabrikan.
Krim vagina mung kanggo administrasi intravaginal lan ora kudu diwenehake kanthi lisan. Kontak karo mripat kudu dihindari.
Dosis
Pasien Pediatrik
Kandidiasis Vulvovaginal Intravaginal Tanpa RumitMycelex-3: Anak ≥12 taun: Siji aplikator Krim 2% (kira-kira 100 mg obat) sapisan dina sadurunge turu sajrone 3 dina berturut-turut. Bisa digunakake kanggo obat mandiri.
Dewasa
Kandidiasis Vulvovaginal Intravaginal sing ora rumitGynazole-1: Siji aplikator krim 2% (kira-kira 100 mg obat) minangka dosis siji.
Mycelex-3: Siji aplikator krim 2% (kira-kira 100 mg obat) sapisan dina sadurunge turu kanggo 3 dina berturut-turut. Bisa digunakake kanggo ngobati mandhiri.
Yen gejala klinis tetep, tes kudu diulang maneh kanggo ngilangi patogen liyane, kanggo konfirmasi diagnosis asli, lan kanggo ngilangi kahanan liyane sing bisa predisposisi pasien menyang vagina berulang. infèksi jamur.
Candidiasis Vulvovaginal Kompleks Candidiasis Vulvovaginal ing Wanita Infèksi HIV IntravaginalGunakake regimen intravaginal padha dianjurake kanggo wanita tanpa infèksi HIV; Nanging sawetara ahli nyaranake durasi 3-7 dina. Regimen pangopènan azole intravaginal bisa dianggep kanggo wong sing ngalami episode berulang; profilaksis primer utawa sekunder rutin (terapi suppressive utawa perawatan kronis jangka panjang) ora dianjurake.
Infeksi Vulvovaginal Kambuh sing Disebabake Candida albicans IntravaginalCDC lan liya-liyane nyaranake regimen intensif awal (7-14 dina azole intravaginal utawa regimen 3-dosis flukonazol oral) kanggo entuk remisi mikologis, diterusake kanthi tepat. regimen pangopènan (regimen 6 sasi flukonazol oral sapisan saben minggu utawa, minangka alternatif, azole intravaginal diwenehake kanthi intermiten).
Infèksi Vulvovaginal Komplikasi Liyane IntravaginalCDC lan liya-liyane nyaranake 7-14 dina azole intravaginal kanggo kandidasis vulvovaginal sing abot, disebabake Candida saliyane C. albicans, utawa kedadeyan ing wanita kanthi kondisi medis sing ndasari.
Pènget
Kontraindikasi
Pènget/PanandhapPènget
Panganggone Produk Lateks utawa Karet
Krim vagina butokonazol ngandhut lenga mineral sing bisa ngrusak produk lateks utawa karet (kalebu kondom lan diafragma kontrasepsi vagina). Panganggone produk kasebut sajrone 72 jam sawise perawatan butokonazol intravaginal ora dianjurake.
Pancegahan Umum
Pamilihan lan Panggunaan Antijamur kanggo Kandidiasis VulvovaginalSadurunge nggunakake butokonazol ing wanita kanthi pratandha lan gejala kandidiasis vulvovaginal, konfirmasi diagnosis kanthi nduduhake ragi utawa pseudohyphae kanthi pemeriksaan mikroskopis langsung keputihan (saline utawa 10% kalium hidroksida [KOH] wet mount utawa pewarnaan Gram) utawa kanthi kultur.
Candida sing diidentifikasi kanthi kultur tanpa ana gejala dudu indikasi kanggo perawatan antijamur amarga kira-kira 10-20% wanita ngandhut Candida utawa ragi liyane ing vagina.
Yen gejala klinis. tetep sawise perawatan utawa kambuh ing 2 sasi, tes kudu diulang kanggo ngilangi patogen liyane, kanggo konfirmasi diagnosis asli, lan kanggo ngilangi kondisi liyane sing bisa predispose pasien kanggo infèksi jamur vagina sing berulang (contone, meteng, infeksi HIV).
Aja nggunakake obat mandiri ing wanita sing durung tau ngalami infeksi ragi vagina sing didiagnosa dening dokter, ing wanita sing lagi ngandhut, utawa wanita sing nandhang diabetes, infeksi HIV, utawa paparan HIV.
Populasi Tertentu
KandhutanKategori C.
CDC nyatakake yen regimen 7 dina saka antijamur azole intravaginal bisa digunakake, yen perlu, kanggo perawatan kandidiasis vulvovaginal nalika ngandhut wanita.
LaktasiOra dingerteni manawa butokonazol intravaginal disebar menyang susu; nggunakake kanthi ati-ati ing wanita nursing.
Panggunaan PediatrikGynazole-1: Safety lan khasiat ora ditetepake ing bocah-bocah.
Mycelex-3: Safety lan khasiat ora ditetepake ing bocah <12 taun umur.
Efek Umum sing Sabar
Vulva/vagina kobong, gatel, perih lan bengkak, nyeri pelvis utawa weteng utawa kram.
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