咪康唑
咪康唑是一種廣譜**咪唑類抗真菌**藥物，主要用於局部治療真菌性皮膚和耳部感染，包括**皮膚癬菌病**（錢癬）和**馬拉色菌性皮炎**。它經常與其他藥物（如氯己定、皮質類固醇或抗生素）聯合配製，以在治療外耳炎和膿皮症時提供協同效應。 > **臨床提示：** 雖然局部使用非常有效，但由於潛在的毒性以及有更安全的全身性替代藥物（如伊曲康唑或氟康唑），咪康唑在獸醫學中極少用於全身性治療。
作用機制: 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*.
各物種劑量
- 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
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
給藥途徑
禁忌症
- Hypersensitivity to miconazole or other azole antifungals
- Ruptured tympanic membrane (for certain otic preparations)
不良反應
- Local irritation
- Erythema
- Pruritus (rare)
監測
- Resolution of clinical signs (pruritus, erythema, scaling)
- Fungal cultures (for dermatophytosis)
- Cytology (for Malassezia)
過量
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 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。