ミコナゾール
ミコナゾールは広域スペクトルの**イミダゾール系抗真菌薬**であり、主に**皮膚糸状菌症**（白癬）や**マラセチア皮膚炎**などの真菌性皮膚および耳の感染症の局所治療に使用されます。外耳炎や膿皮症の治療において相乗効果を得るため、他の薬剤（クロルヘキシジン、コルチコステロイド、抗生物質など）と配合されることがよくあります。 > **臨床のポイント：** 局所的には非常に有効ですが、潜在的な毒性があり、イトラコナゾールやフルコナゾールなどのより安全な全身性代替薬があるため、獣医学においてミコナゾールが全身的に使用されることはまれです。
作用機序: Miconazole works by inhibiting the **cytochrome P450-dependent enzyme 14-alpha-demethylase** in fungal cells. Inhibition of 14-alpha-demethylase → depletion of **ergosterol** (a vital component of the fungal cell membrane) → accumulation of toxic sterol precursors → increased cell wall permeability → leakage of cellular contents and subsequent fungal cell death. It has potent activity against *Malassezia*, *Cryptococcus*, *Candida*, and *Coccidioides*.
動物種別の用量
- Fungal otitis · 2-12 drops in affected ear · topical · q12-24h · Surolan formulation
- Fungal otitis · 1 ml per ear · topical · q24h · 5 days · Easotic formulation
- Fungal otitis · 5 drops in affected ear · topical · q12h · Aurimic formulation
- Dermatophytosis · Apply a thin layer of cream topically to affected area · topical · bid · Continue for 2 weeks after a clinical cure and negative fungal cultures · Daktarin formulation
- Malassezia dermatitis · Shampoo twice weekly until the clinical signs subside and weekly thereafter or as necessary · topical · twice weekly · Until clinical signs subside, then weekly · Malaseb, Adaxio formulations
- Small localized skin infections · Apply a few drops to affected skin · topical · q12h · Aurimic formulation
- Fungal otitis · 2-12 drops in affected ear · topical · q12-24h · Surolan formulation
- Fungal otitis · 1 ml per ear · topical · q24h · 5 days · Easotic formulation
- Fungal otitis · 5 drops in affected ear · topical · q12h · Aurimic formulation
- Dermatophytosis · Apply a thin layer of cream topically to affected area · topical · bid · Continue for 2 weeks after a clinical cure and negative fungal cultures · Daktarin formulation
- Dermatophytosis (generalized) · Shampoo twice weekly · topical · twice weekly · Concurrent systemic itraconazole administration is required
- Malassezia dermatitis · Shampoo twice weekly until the clinical signs subside and weekly thereafter or as necessary · topical · twice weekly · Until clinical signs subside, then weekly · Malaseb, Adaxio formulations
- Small localized skin infections · Apply a few drops to affected skin · topical · q12h · Aurimic formulation
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Hypersensitivity to miconazole or other azole antifungals
- Ruptured tympanic membrane (for certain otic preparations)
有害事象
- Local irritation
- Erythema
- Pruritus (rare)
モニタリング
- Resolution of clinical signs (pruritus, erythema, scaling)
- Fungal cultures (for dermatophytosis)
- Cytology (for Malassezia)
過量投与
Overdose is highly unlikely with topical administration. Accidental ingestion of shampoos or creams may cause mild gastrointestinal upset (hypersalivation, vomiting, diarrhea). Treatment is symptomatic and supportive.
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。