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Antifungal agents are available in systemic and topical formulations,
and some are available in both forms. Topical antifungal agents,
because they are poorly absorbed, are less likely to cause toxicity
and should, as a rule, be the first choice for treating skin and
mucous membrane infections. However, tinea capitis and onychomycosis (fungal
infection of the nails) are best treated systemically (see Chapter 367). Infections that are severe,
are disseminated, or involve the bloodstream should also be treated
with systemic therapy. During the past 10 years, many potent new
systemic agents have become available. Organism- and disease-specific
antifungal therapies are summarized in Table 247-1.
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