Bifonazol – In-vitro-Wirksamkeit gegenüber Corynebacterium minutissimum – ein Update zur Diagnostik und Therapie des Erythrasmas

 

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Zusammenfassung

Corynebacterium minutissimum wird als bakteriologische Ursache des Erythrasmas angesehen. Die Behandlung erfolgt mit topischen, manchmal systemischen Antibiotika, häufiger jedoch mit topischen Antimykotika aus der Gruppe der Imidazole. Neben Clotrimazol ist das vor allem Bifonazol, welches für diese Indikation zugelassen und wirksam ist. Es wurden 24 Stämme unterschiedlicher Corynebacterium-Arten, darunter Corynebacterium (C.) minutissimum, sowie einzelne Stämme von weiteren grampositiven Bakterien-Spezies, hinsichtlich ihrer In-vitro-Empfindlichkeit gegenüber Bifonazol untersucht. Zur Anwendung kam ein Agardilutionstest, mit dessen Hilfe minimale Hemmkonzentrationen (MHK) für Bifonazol bestimmt werden können.

Bifonazol zeigte gegenüber allen getesteten Corynebacterium-Spezies und -Stämmen eine sehr gute In-vitro-Aktivität. Die MHK-Werte lagen bei 0,05 bis 1,56 µg/ml⁻¹ (10⁶ KbE/ml⁻¹). Bei einer Bakteriendichte von 10⁸ KbE/ml⁻¹ ergaben sich MHK-Werte von 0,1 bis 1,56 µg/ml⁻¹. Es hat sich gezeigt, dass Bifonazol in vitro eine sehr gute Wirksamkeit gegenüber Corynebacterium spp. hat. Das betrifft offensichtlich nicht nur C. minutissimum, sondern auch die anderen – hier getesteten – Corynebacterium-Arten. Das waren C. accolens, C. argentoratense, C. jeikeium, C. macginleyi, C. propinquum und C. pseudotuberculosis.

Abstract

The gram-positive bacteria Corynebacterium minutissimum are known as causative agent of the erythrasma. The treatment is based on the application of topical antibiotics, sometimes oral antibiotics have to be used. However, more frequently, topical antifungal agents of the imidazole group are used for erythrasma. This is, after clotrimazole, first of all bifonazole, which is approved for treatment of this superficial bacterial infection of the skin, and has been shown to be efficient in this dermatosis.

Altogether, 24 strains of different species of the genus Corynebacterium, among them Corynebacterium (C.) minutissimum, and single strains of further species of other gram-positive bacteria, were investigated for their in vitro susceptibility against bifonazole. An agar dilution test was used for determination of minimum inhibitory concentration (MIC) of bifonazole.

Bifonazole showed a very good in vitro activity against all tested species and strains of Corynebacterium. MIC values were in a range from 0.05 until 1.56 µg ml⁻¹ (10⁶ cfu [colony forming units] ml⁻¹). At a higher densitiy of bacteria (10⁸ cfu ml⁻¹) MIC values at a range from 0.1 until 1.56 µg ml⁻¹ were found. In conclusion, it could be demonstrated that bifonazole exhibits a very good in vitro activity against Corynebacterium spp.

Obviously, this concerns not only the species C. minutissimum, but also the other tested species of Corynebacterium, which were C. accolens, C. argentoratense, C. jeikeium, C. macginleyi, C. propinquum, and C. pseudotuberculosis.

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