Antifungals - Prescribing errors

Canesten AF spray is clotrimazole, a member of the imidazole family of antifungal drugs (known as Lotrimin or Mycelex in the US). It works by destroying the cell-membrane structure of the fungi.

Sometimes, clotrimazole is combined with a potent steroid, as in the drug marketed as Lotrisone, and doctors seem to be equally clueless as to the indications for this drug. Although Lotrisone is only approved for the treatment of fungal infections in adults and children over 12, a US survey of 106 paediatricians found that 23 per cent of those routinely prescribing this combo drug did so it inappropriately for nappy rash. Only 18 per cent of the surveyed prescribing paediatricians even knew that the drug was a high-potency steroid (Dermatol Online J, 2002; 8: 3)!

Many patients have contact allergy to these drugs - a problem that is growing the more the drugs are prescribed. According to one Japanese study, 30 per cent of users were allergic (Nippon Ika Daigaku Zasshi, 1996; 63: 356-64).