Balanitis in Emergency Medicine Medication
- Author: Mark J Leber, MD, MPH, FACEP; Chief Editor: Erik D Schraga, MD more...
Medication Summary
The goal of balanitis therapy is to eradicate infection and prevent complications.
Antimicrobial agents (topical)
Class Summary
Therapy must cover all likely pathogens in the context of the clinical setting.
Clotrimazole topical (Mycelex, Lotrimin)
Broad-spectrum antifungal agent that inhibits yeast growth by altering cell membrane permeability. For adult use, especially those with a positive history of candidiasis in a sexual partner.
Bacitracin (AK-Tracin)
Prevents transfer of mucopeptides into growing cell wall, which inhibits cell wall synthesis and bacterial growth. More commonly used in pediatric patients or patients who are not sexually active.
Corticosteroids, topical
Class Summary
These agents have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune response to diverse stimuli.
Betamethasone 0.05% (Alphatrex, Diprolene, Maxivate)
For treatment of inflammatory dermatoses responsive to steroids. Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing capillary permeability. Affects production of lymphokines and has inhibitory effect on Langerhans cells.
Immunosuppressant agents
Class Summary
Regulates key factors responsible for the immune response.
Pimecrolimus (Elidel cream)
First nonsteroid cream approved in the US for mild-to-moderate atopic dermatitis. Derived from azcomycin, a natural substance produced by fungus Streptomyces hygroscopics var. ascomycetous. Selectively inhibits production and release of inflammatory cytokines from activated T-cells by binding to cytosolic immunophilin receptor macrophilin-12. The resulting complex inhibits phosphatase calcineurin, thus blocking T-cell activation and cytokine release. Cutaneous atrophy was not observed in clinical trials, a potential advantage over topical corticosteroids. Indicated only after other treatment options have failed.
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