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Addressing filamentous fungi-related onychomycosis in the era of antifungal resistance: assessment of Zataria multiflora nanostructured lipid carrier topical gel in a double-blinded clinical trial

Summary

Nail fungal infections (onychomycosis) are difficult to treat, especially as fungi become resistant to standard antifungal medications. Researchers tested a new gel made from Zataria multiflora (Shirazi thyme) packaged in special nanoparticles that help the medicine penetrate the nail better. In a clinical trial comparing this gel to placebo, the Zataria multiflora treatment showed better results after just 2 weeks, with 70% of patients experiencing fungal cure compared to 55% with placebo.

Background

Onychomycosis is a prevalent fungal infection affecting nails that presents significant clinical treatment challenges. The emergence of antifungal resistance, particularly terbinafine resistance, necessitates novel therapeutic approaches. Zataria multiflora has demonstrated antifungal properties and presents a promising approach for treatment.

Objective

This study evaluated the effectiveness of Zataria multiflora-loaded nanostructured lipid carriers (Zat-NLC) 1% gel against mold-associated onychomycosis compared to placebo in a double-blind clinical trial. The objective was to assess both clinical symptoms and mycological findings following topical administration.

Results

Zat-NLCs demonstrated significant inhibitory effects on dermatophytes and non-dermatophyte fungi in vitro. After 2 weeks of treatment, mycological cure rate was 70% for Zat-NLC gel compared to 55% for placebo (P<0.005). The predominant isolated species were T. mentagrophytes/interdigitale complex and Aspergillus section Flavi as dermatophytes and non-dermatophytes, respectively.

Conclusion

Nanostructured lipid carrier systems loading with antifungals represent a more efficient therapeutic approach for mold-related dermatophytosis. Zataria multiflora-loaded nanostructured lipid carriers showed promising antifungal properties offering a swift and effective treatment alternative for onychomycosis caused by filamentous fungi. Further independent research without standard medication is necessary to fully evaluate these agents.
  • Published in:Current Medical Mycology,
  • Study Type:Clinical Trial,
  • Source: 10.22034/cmm.2024.345248.1582, PMID: 41122119
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