WO2017216722A2 - Compositions antifongiques synergiques et leurs procédés - Google Patents

Compositions antifongiques synergiques et leurs procédés Download PDF

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WO2017216722A2
WO2017216722A2 PCT/IB2017/053505 IB2017053505W WO2017216722A2 WO 2017216722 A2 WO2017216722 A2 WO 2017216722A2 IB 2017053505 W IB2017053505 W IB 2017053505W WO 2017216722 A2 WO2017216722 A2 WO 2017216722A2
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Prior art keywords
acid
excipient
antifungal
ester
propylene glycol
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PCT/IB2017/053505
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English (en)
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WO2017216722A3 (fr
Inventor
Shamik GHOSH
Sumana GHOSH
Mau SINHA
Suresh SADHASIVAM
Anubhuti JAIN
Anamika BHATTACHARYYA
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Vyome Biosciences Pvt. Ltd.
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Priority to EA201990025A priority Critical patent/EA201990025A1/ru
Priority to JP2018566346A priority patent/JP2019521993A/ja
Priority to EP17742542.8A priority patent/EP3468544A2/fr
Priority to AU2017283785A priority patent/AU2017283785A1/en
Priority to CN201780049586.2A priority patent/CN109689034A/zh
Priority to MX2018015475A priority patent/MX2018015475A/es
Application filed by Vyome Biosciences Pvt. Ltd. filed Critical Vyome Biosciences Pvt. Ltd.
Priority to KR1020197001063A priority patent/KR20190037229A/ko
Priority to BR112018075998-8A priority patent/BR112018075998A2/pt
Priority to US16/309,751 priority patent/US20190142800A1/en
Publication of WO2017216722A2 publication Critical patent/WO2017216722A2/fr
Publication of WO2017216722A3 publication Critical patent/WO2017216722A3/fr
Priority to PH12018550205A priority patent/PH12018550205A1/en

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    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61K31/185Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19Carboxylic acids, e.g. valproic acid
    • AHUMAN NECESSITIES
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    • A61K31/137Arylalkylamines, e.g. amphetamine, epinephrine, salbutamol, ephedrine or methadone
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    • A61K31/19Carboxylic acids, e.g. valproic acid
    • A61K31/20Carboxylic acids, e.g. valproic acid having a carboxyl group bound to a chain of seven or more carbon atoms, e.g. stearic, palmitic, arachidic acids
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    • A61K31/19Carboxylic acids, e.g. valproic acid
    • A61K31/20Carboxylic acids, e.g. valproic acid having a carboxyl group bound to a chain of seven or more carbon atoms, e.g. stearic, palmitic, arachidic acids
    • A61K31/201Carboxylic acids, e.g. valproic acid having a carboxyl group bound to a chain of seven or more carbon atoms, e.g. stearic, palmitic, arachidic acids having one or two double bonds, e.g. oleic, linoleic acids
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    • A61K31/215Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A61K31/22Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin
    • A61K31/23Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin of acids having a carboxyl group bound to a chain of seven or more carbon atoms
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    • A61K31/215Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A61K31/22Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin
    • A61K31/23Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin of acids having a carboxyl group bound to a chain of seven or more carbon atoms
    • A61K31/231Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin of acids having a carboxyl group bound to a chain of seven or more carbon atoms having one or two double bonds
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    • A61K31/335Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/34Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having five-membered rings with one oxygen as the only ring hetero atom, e.g. isosorbide
    • A61K31/343Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having five-membered rings with one oxygen as the only ring hetero atom, e.g. isosorbide condensed with a carbocyclic ring, e.g. coumaran, bufuralol, befunolol, clobenfurol, amiodarone
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    • A61K31/407Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with other heterocyclic ring systems, e.g. ketorolac, physostigmine
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    • A61K31/41Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
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    • A61K31/41641,3-Diazoles
    • A61K31/4174Arylalkylimidazoles, e.g. oxymetazolin, naphazoline, miconazole
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    • A61K31/41Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/41641,3-Diazoles
    • A61K31/41781,3-Diazoles not condensed 1,3-diazoles and containing further heterocyclic rings, e.g. pilocarpine, nitrofurantoin
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    • A61K31/41Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/41961,2,4-Triazoles
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    • A61K31/42Oxazoles
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    • A61K31/495Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/496Non-condensed piperazines containing further heterocyclic rings, e.g. rifampin, thiothixene
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    • A61K31/505Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/506Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim not condensed and containing further heterocyclic rings
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    • A61K31/7034Compounds having saccharide radicals attached to non-saccharide compounds by glycosidic linkages attached to a carbocyclic compound, e.g. phloridzin

Definitions

  • the present invention relates to the field of antimicrobials and pharmaceutical sciences.
  • the invention provides antifungal compositions for the management of fungal growth and treatment of fungal infections, including treatment of resistant fungal infections.
  • the present compositions comprise an antifungal agent and a medium-chain saturated or unsaturated fatty acid or ester thereof, optionally along with excipient(s), giving rise to a synergistic antifungal activity.
  • Fungal infections of the skin are also known as 'mycoses'. They are common and generally mild. In sick or otherwise immune-suppressed individuals, however, fungi can sometimes cause serious disease. Fungal infections in humans range from superficial, i.e., skin surface to deeply invasive type or disseminated infection.
  • superficial fungal infections can affect the outer layers of skin, nails and hair.
  • the main groups of fungi causing superficial fungal infections are dermatophytes (Trichophyton spp.), yeasts, e.g., Candida, Malassezia, piedra, etc. and moulds.
  • the fungal infections include dermatophytoses, cutaneous candidiasis, dandruff/seborrheic dermatitis (D/SD), onycholysis, intertrigo, and those in psoriasis, atopic dermatitis amongst others.
  • Dermatophytes are one of the most common filamentous fungal species infecting regions rich in keratin, such as the hair, skin, and nails. They generally grow as branched hyphae inside the layers of stratum comeum. (Weitzman and Summerbell 1995, Clin. Microbiol Rev. 8: 240; Hainer 2003, Am Fain Physician 67: 101). Dermatophytoses, also known as tinea, are rampant among the human population. Tinea can occur at various parts of the body and defined accordingly: tinea capitis (head), tinea corporis and tinea cruris (trunk and groin), tinea pedis (foot), tinea unguium or onychomycosis (nail) etc.
  • Trichophyton rubrum Trichophyton mentagrophyteSy Trichophyton verrucosum
  • Microsporum cards Microsporum gypseum and Epidermophyton floccosimi are the major pathogens responsible for dermatophytoses (Weitzman and Summerbell 1995, Clin Microbiol Rev 8: 240; White et a/ 2008, Eukaryot Cell 7: 1238).
  • Dermatophvtic infections manifest as skin lesions which are usually round, erythematous, and itchy due to the inflammatory response triggered by the fungus and its metabolites (Hube et al 2015, J Mycol Med 25:e44). The infection can be mild to severe, depending on the host immune response.
  • Onychomycosis refers to any fungal infection of the nail where the causative factor can be dermatophytes, yeast or non-dermatophyte moulds. Most toe-nail infections are caused by T. ruhnim and T. inter -digitale. while yeasts ⁇ Candida albicans) are the mostly associated with fingernail infections (Eldridge et al 2014, Expert Rev Anti Infect Ther 12: 1389). In onychomycosis, nails become thicker and separated from the nail bed; white spots and dystrophy may also occur (Trepanier EF and Amsden 1998, Ann Pharmacother 32: 204). Treatment of onychomycosis is a serious challenge due to poor drug penetrability and hence high recurrence rates.
  • dermatophyte infections are restricted to areas of the epidermis, they can be invasive and cause serious widespread infections in immunocompromised patients, with the development of granulomas (Peres et al 2010, An Bras Dermatol 85: 657).
  • Cutaneous candidiasis is an infection caused by yeasts of the genus Candida. Infections mainly in the mucous membranes of the skin folds are most rampant due to moist conditions.
  • the spectrum of cutaneous candidiasis includes diaper rash, interdigital candidiasis, Candida folliculitis, otomycosis, onychia and paronychia.
  • Candida skin infections are mostly associated with erythema, cracking, or maceration (Hay RJ 1992, Arch Dis Child 67: 1065; Zuber and Baddam 2001, Postgrad Med 109: 1 17).
  • Candida albicans has been regarded as the most common causative agent.
  • Candida spp. is responsible for systemic infections in various parts of the human body, including oral cavity, vaginal mucosa, bloodstream and internal organs (Kauffman 2006, Proc Am Thorac Soc 3: 35 ).
  • Candida albicans, Candida glabrata, Candida parapsUosis, Candida tropicalis, and Candida krusei can cause superficial infections of the oral and vaginal mucosa as well as disseminated bloodstream and deep-tissue infections.
  • Most Candida spp. produce virulence factors including protease factors and the ability of these yeast forms to adhere to the underlying epithelium is an important step in the production of hyphae and tissue penetration.
  • Candida albicans can also cause deep invasive disease, associated with surgically implanted devices including indwelling intravenous catheters, orthopaedic devices, urinary catheters, intrauterine devices, dialysis vascular grafts and central nervous system implants (Inabo 2006, Scientific Research and Essay 1 : 008).
  • Candida infections associated with these diseases generally form biofilms by adhering to the surface of implants.
  • Biofilms of Candida albicans, Candida parapsUosis, Candida glahrata and Candida tropicalis are associated with high indices of hospital morbidity and mortality.
  • Seborrheic dermatitis is a common, chronic, superficial skin disorder causing scaly, itchy, red skin on the scalp, eyebrows, nasolabial creases, lips, ears, sternal area, axillae, submammary folds, umbilicus, groins, and gluteul crease.
  • the disease is characterized by many shapes, sizes, and surface textures and is often crust-like, yellowish, and accompanied by itching.
  • Seborrheic dermatitis is one of the leading causes of stubborn dandruff and occurs in all age groups. This condition primarily affects the sebaceous cysts present in the skin.
  • fungi of the genus Malassezia are believed to be the most likely responsible agents for causing dandruff (Dawson T. L., J. Investig. Dermatol. Symp. Proc. (2007), 12: 1519). Most cases of seborrhoeic dermatitis likely involve an inflammatory reaction to the proliferation of the yeast Malassezia. These fungi are highly dependent on external lipids for in vitro growth (Chen T. A. and Hill P. V., Vet Dermatol, (2005), 16:4). Further, the inability to synthesize fatty acids may be complimented by the presence of multiple secreted lipases to aid in utilizing host lipids.
  • lipid by-products Penetration of the top layer of the epidermis, the stratum corneum, by these lipid by-products results in an inflammatory response in susceptible persons, which disturbs homeostasis causing erratic cleavage of stratum corneum ceils, further leading to dandruff and seborrheic dermatitis.
  • antifungal drugs available to treat fungal infections. They include azoies, allylamines, polyenes, pyrimidine analogs, and echinocandins.
  • RNA, DNA nucleic acids
  • Echinocandins like caspofungin, micofungin block the catalytic subunit of the ⁇ -1 ,3 glucan synthase and thus inhibit cell wall biosynthesis (Sanglard D., 2016, Front Med (Lausanne) 3: 1 1).
  • Zinc pyrithione mostly used for the treatment of seborrhoeic dermatitis has fungistatic activity by inhibiting the division of fungal ceils.
  • Piroctone olamine exerts its antimycotic action by inhibiting energy metabolism in mitochondria of pathogenic fungi (Dupont et al 2002, Arch Surg 137: 1341).
  • Topical agents or oral antifungals are prescribed based on the severity of the fungal infection.
  • Treatment of onychomycosis includes antifungal nail lacquer of ciclopirox or amoroifme. Amorolphine, a morpholine antifungal also depletes ergosteroi.
  • Topical efinaconazole was recently approved for the treatment of onychomycosis and after 4 weeks of therapy, cure has been observed in 15-18% of patients (Elewski et al 2013, J Am Acad Dermatol 68: 600).
  • oral terbinafine is typically recommended as first-line therapy.
  • the most common treatment of Malassezia infections is the topical application of antifungal agents that reduce the level of the fungus on the scalp. Maintaining the scalp clean is mandatory for sufferers of seborrheic dermatitis.
  • Use of effective anti-dandruff shampoos is, therefore, a significant way of preventing this condition.
  • the antifungal agent is applied to the scalp as a component of a shampoo or other hair care composition.
  • the disadvantage of such shampoo formulations is that during normal usage the formulation does not remain on the scalp for a period of time sufficient to allow the antifungal agent to achieve its maximal therapeutic effect (Ralph M. Trueb, JDDG, (2007), 5:356).
  • ketoconazole is among the most potent and widely used in anti- dandruff shampoos. However, the exposure time of shampoo is less, due to which the efficacy is poor and relapse rates are higher.
  • MIC values given in microgram per milliliter
  • MIC of certain isolates are significantly higher than a wild type population, then they are suspected of resistant type. It helps clinicians to decide the future course of treatment with alternative agents. The majority of resistance mechanisms against these antifungals have also been elucidated at the molecular level in these pathogens.
  • U.S. Patent Application 2010/0016271 discloses hair conditioning compositions comprising cationic surfactant, triglyceride oil and an anti-dandruff agent. These compositions contain triglyceride oil, which are fatty acid esters of glycerol, and hence act as nutrients and aid in the growth of the fungus. These compositions contain fatty acid material up to 30% having carbon chains from 8 to 30 carbon atoms.
  • U.S. Patent No. 5624666 describes shampoo compositions containing anionic surfactants, cationic polymers, and zinc pyrithione as an anti-dandruff agent. It describes that conditioning agents such as silicone fluids can optionally be incorporated into the compositions therein. Head & Shoulders® Dandruff Shampoo Plus Conditioner is an example of a marketed product which provides both anti-dandruff and conditioning benefits upon application of the shampoo to hair. However, relapse rates by the use of said products are higher.
  • the present invention provides improved antifungal compositions which are targeted to overcome drawbacks associated with these prior arts and others that are generally available in the art. OBJECTIVE OF THE INVENTION
  • the primary objective of the invention is to provide improved/synergistic antifungal compositions.
  • Said antifungal compositions comprise an antifungal agent, a fatty acid (C-l to C14) and/or esters thereof, optionally along with excipients or additives.
  • Yet another objective of the invention is to provide antifungal compositions devoid of more than C-l 4 fatty acids or their esters for the treatment of topical fungal infections or management of fungal growth.
  • Still another objective of the invention is to provide synergistic compositions for the treatment of fungal infections or management of fungal growth, against both resistant and non-resistant fungi.
  • Figure 1A is a schematic representation of the checkerboard assay to test synergistic, additive or antagonistic effects of two test agents.
  • Figure IB is a representative data set for checkerboard assay of clotrimazole and oleic acid in C. albicans.
  • Figure 1C is a graphical representation of the decrease in potency of clotrimazole with increasing concentrations of oleic acid.
  • FIG. 2 is a photograph showing the effect of nutrients/fatty acids or their esters provided in the culture media on the growth of M. furfur (MTCC 1374).
  • Figure 3 is a graphical representation showing that propylene glycol monocaprylate in a formulation with an allylamine is active/synergistic against terbinafine resistant Trichophyton interdigitale (GTB-2S) in an in vitro time kill assay.
  • GTB-2S terbinafine resistant Trichophyton interdigitale
  • Figure 4 shows comparison of exemplary compositions of the invention comprising clotrimazole formulations vs marketed clotrimazole formulations in an azoie resistant T. riihrum strain (GTB- 3FR-TS).
  • Figure 5 shows comparison of exemplary compositions of the invention comprising clotrimazole vs marketed clotrimazole formulations in an azoie resistant C. albicans strain (MTCC-227).
  • Figure 6 is a graphical representation showing that propylene glycol monocaprylate in an exemplary formulation with an azoie (Miconazole) is active/synergistic against azoie resistant C, albicans (MTCC-227) in an in vitro time kill assay.
  • Figure 7 shows comparison of exemplary compositions of the invention comprising comprising propylene glycone nionocaprylate and luliconazole vs marketed luliconazole formulations in an azoie resistant C. albicans strain (MTCC-227).
  • Figure 8 is a graphical representation showing that exemplary composition of the invention comprising clotrimazole and propylene glycol nionocaprylate has higher/synergistic efficacy in a cutaneous candidiasis animal model using azole resistant C, albicans (MTCC 227).
  • Figure 9 shows that an exemplary composition of the invention comprising luliconazole and with propylene glycol nionocaprylate has higher/synergistic efficacy in a murine tinea model using a pathogenic Trichophyton mentagrophyte strain (ATCC 24953).
  • Figare 10 is a graphical representation showing enhanced efficacy of exemplary shampoo formulation containing ketoconazole (2%) and ester derivatives of caprylic acid compared to marketed ketoconazoie shampoo formulations in an in vitro time kill assay against M. furfur (MTCC 1374),
  • Table 1 Representative data from checkerboard assays of combination of caprylic acid (C8) with antifungals (various classes) on Trichophyton rubrum (ATCC 28188),
  • Table 2 Representative data from checkerboard assays of combination of propylene glycol nionocaprylate (caprylic acid ester) with antifungais (various classes) on Trichophyton rubrum (ATCC 28188).
  • Table 3 Representative data from checkerboard assays of combination of glyceryl nionocaprylate with antifungais (various classes) on Trichophyton rubrum ( ATCC 28188),
  • Table 4 Representative data from checkerboard assays of combination of undecylinic acid (C 11) with antifungais (various classes) on Trichophyton rubrum (ATCC 28188).
  • Table 5 Representative data from checkerboard assays of combination of lauric acid (C12) with antifungais (various classes) on Trichophyton rubrum (ATCC 28188).
  • Table 6 Representative data from checkerboard assays of combination of propylene glycol monolaurate (lauric acid ester C12 fatty acid) with antifungais (various classes) on Trichophyton rubrum (ATCC 28188),
  • Table 7 Representative data showing synergistic action of terbinafine or butenafine with caprylic acid (C8), or its esters (propylene glycol nionocaprylate and glyceryl nionocaprylate) against terbinafine resistant T ' richophyton interdigitale (GTB-2S).
  • Table 8 Representative data from checkerboard assays of combinations of Miconazole with caprylic acid (C8) or glyceryl monocaprylate on C. albicans (ATCC-90028).
  • Table 9 Representative data from checkerboard assays of combination of capiylic acid (C8) with variousantifungals on azole resistant C. albicans MTCC 227.
  • Table 10 Representative data from checkerboard assays of combination of propylene glycol monocaprylate (C8 ester) with various antifungals on azole resistant C. albicans MTCC 227.
  • Table 11 Representative data from checkerboard assays of combination of glyceryl monocaprylate (C8 ester) with various antifungals on azole resistant C. albicans MTCC 227.
  • Table 12 Representative data from checkerboard assays of combination of undecylenic acid (CI 1) with various antifungals on azole resistant C. albicans MTCC 227.
  • Table 13 Representative data from checkerboard assays of combination of lauric acid (CI 2) with various antifungals on azole resistant C, albicans MTCC 227.
  • Table 14 Representative data from checkerboard assays of combination of propylene glycol monolaurate (ester of C12 fatty acid) with various antifungals on azole resistant C. albicans MTCC 227.
  • Table 15 Piroctone olamine based oil compositions containing Caprylic acid (C8 fatty acid).
  • Table 16 Ketoconazole based oil compositions containing Caprylic acid (C8 fatty acid).
  • Table 17 Results of minimum inhibitor ⁇ ' concentration (MIC) for oil compositions of piroctone olamine and capiylic acid.
  • Table 18 Results of MIC for oil compositions of ketoconazole and caprylic acid against M furfur (MTCC 1374).
  • Table 19 Oil compositions containing piroctone olamine as antifungal agent and capiylic acid and/or its ester.
  • Table 20 MIC of oil compositions containing piroctone olamine and caprylic acid and/or its ester against M. furfur (MTCC 1374).
  • Table 21 MIC for oil compositions containing piroctone olamine and caprylic acid and/or its ester against M obtusa (CBS 7876).
  • Table 22 Oil compositions containing ketoconazole as antifungal agent and caprylic acid and/or its ester.
  • Table 23 Oil compositions containing piroctone olamine and ketoconazole in combination with caprylic acid and/or its ester.
  • Table 24 Oil compositions containing piroctone olamine as antifungal agent, Minoxidil and caprylic acid and/or its ester.
  • Table 25 Gel compositions containing antifungal agents devoid of C- 15 or greater fatty acids/esters.
  • Table 26 Zone of inhibition of gel compositions containing piroctone olamine and caprylic acid and/or its ester against M, furfur.
  • Table 27 Preparation of cream compositions containing antifungal agents piroctone olamine or ketoconazole and caprylic acid ester derivative.
  • Table 28 Exemplary clotrimazole (1 %) topical cream formulations with at least one or two medium chain fatty acids (C-l to C- 14) and derivatives thereof.
  • Table 29 Exemplary iuliconazole (1%) topical cream formulations with at least one or two medium chain fatty acids (C- l to C- 14) and derivatives thereof.
  • Table 30 Exemplary topical cream formulations containing 1 % terbmafine with at least one or two medium chain fatty acids (C- l to C- 14) and derivatives thereof.
  • Table 31 Exemplary Iuliconazole (1 %) topical lotion formulations without ethanol and containing at least one or two medium chain fatty acids (C-l to C-14) and derivatives thereof.
  • Table 32 Exemplary iuliconazole (3 %) topical lotion formulations with ethanol and containing at least one or two medium chain fatty acids (C-l to C-14) and derivatives thereof.
  • Table 33 Exemplary topical nail solutions containing 1% efinaconazole with at least one or two medium chain fatty acids (C-l to C- 14) and derivatives thereof.
  • Table 34 Exemplary topical shampoo formulations containing ketoconazole or combination of ketoconazole- zinc pyrithione (ZPTO) with structured surfactants containing at least one or two medium chain fatty acids (C-l to C- 14) and derivatives thereof.
  • ZPTO ketoconazole- zinc pyrithione
  • Table 35 Exemplary topical shampoo formulations containing ketoconazole with mild sulphate free surfactants containing at least one or two medium chain fatty acids (C-l to C- 14) and derivatives thereof.
  • Table 36 Exemplary hair serum formulations containing an antifungal agent with at least one or two medium chain fatty acids (C-l to C-14) and derivatives thereof.
  • Table 37 Exemplary body lotion formulations containing an antifungal agent with at least one or two medium chain fatty acids (C-l to C-14) and derivatives thereof.
  • Table 38 Exemplary formulations for coating surgical implants containing an antimicrohial/antifungal agent with at least one or two medium chain fatty acids (C-l to C-14) and derivatives thereof.
  • the present invention showcases that specific fatty acids, especially medium chain fatty acids (CI to CI 4) and esters thereof demonstrate synergistic antifungal activity in combination with various antifungal agents. Moreover, the invention proves that fatty acids and/or esters in combination with various antifungal agents demonstrate synergistic antifungal activity against drug-resistant fungi in addition to drug-susceptible fungi.
  • specific fatty acids especially medium chain fatty acids (CI to CI 4) and esters thereof demonstrate synergistic antifungal activity in combination with various antifungal agents.
  • fatty acids and/or esters in combination with various antifungal agents demonstrate synergistic antifungal activity against drug-resistant fungi in addition to drug-susceptible fungi.
  • the present invention provides antifungal compositions that comprise at least an antifungal agent and a fatty acid (CI to CI 4) or ester thereof.
  • the antifungal composition of the invention further comprises at least one excipient.
  • the antifungal composition of the invention is devoid of C-l 5 or greater fatty acids or their esters as these long chain fatty acids/esters serve as nutrients for the growth of the fungus.
  • the present invention shows that such long chain fatty'' acids/esters help in enhancing the fungal growth rather than growth inhibition.
  • the antifungal composition comprises an antifungal agent, a fatty acid with less than C-l 5 chain length or its ester (synergistic to the antifungal agent), and at least one excipient.
  • the antifungal composition comprises an antifungal agent, a fatty acid (Ci to CI 4) or its ester thereof (synergistic to the antifungal agent), and at least one excipient.
  • the synergistic antifungal composition of the invention comprises an antifungal agent, a fatty acid (C 11 to CI 4) or its ester thereof (synergistic to the antifungal agent), and at least one excipient.
  • the synergistic antifungal composition comprises an antifungal agent, a fatty acid (CI to CIO) or its ester thereof (synergistic to the antifungal agent), and at least one excipient.
  • the synergistic antifungal composition of the invention comprises an antifungal agent, a fatty acid having carbon chain length of C8 or its ester thereof, and at least one excipient.
  • the present invention provides antifungal compositions formulated for topical, local or systemic delivery for management of fungal growth including growth caused by drug-resistant fungi.
  • the present invention provides antifungal compositions formulated for topical, local or systemic delivery for treatment of skin based fungal infections including infections caused by drug- resistant fungi.
  • the present invention further provides antifungal creams or lotions fonnulated for topical, local or systemic delivery for treatment of tinea infections or prevent or reduce relapse of tinea infections.
  • the present invention further provides antifungal creams or lotions formulated for topical, local or systemic deliver ⁇ ' for treatment of seborrheic dermatitis or prevent or reduce relapse of the same.
  • the present disclosure provides antifungal cream or lotions fonnulated for topical, local or systemic delivery for treatment of Candida infections.
  • the present disclosure also provides antifungal solutions/compositions for treating or managing nail infections.
  • the present invention further provides topical antifungal oil compositions that eliminate existing dandruff on the scalp, or prevent or reduce relapse of dandruff formation.
  • the present invention further provides antifungal shampoo formulations fonnulated for topical, local or systemic delivery for treatment of fungal infections of the scalp (like dandruff, tinea capitis).
  • the present disclosure further describes antifungal compositions that can be used for the treatment of surgical implant associated fungal infections including drug-resistant or drug- susceptible fungal infections.
  • the disclosure also provides use of present antifungal compositions for management of fungal growth or treatment of fungal infections as described herein.
  • the present disclosure further provides methods of preparing antifungal compositions described herein.
  • the present disclosure relates to an antifungal composition
  • an antifungal composition comprising at least one antifungal agent, at least one fatty acid or ester thereof, and optionally one or more excipient, wherein the fatty acid has a carbon chain length ranging from C-l to C-14, and wherein the composition has synergistic antifungal activity.
  • the fatty acid or ester thereof in the antifungal composition is a saturated or unsaturated fatty acid or ester of said saturated or unsaturated fatty acid.
  • the fatty acid in the antifungal composition has a carbon chain length ranging from C- l 1 to C-14.
  • the fatty acid in the antifungal composition has a carbon chain length ranging from C-l to C-10.
  • the fatty acid in the antifungal composition is selected from the group consisting of formic acid (CI), acetic acid (C2), propionic acid (C3), butyric acid (C4), valeric acid (C5), caproic acid (C6), enanthic acid (C7), caprylic acid (C8), pelargonic acid (C9), capric acid (CIO), undecylic acid (CM ), lauric acid (C12), tridecylic acid (CI 3), myristic acid (CI 4) and corresponding unsaturated fatty acids thereof.
  • CI formic acid
  • C2 acetic acid
  • propionic acid C3
  • butyric acid C4
  • valeric acid C5
  • caproic acid C6
  • enanthic acid C7
  • caprylic acid C8
  • pelargonic acid C9
  • capric acid CIO
  • undecylic acid CM
  • lauric acid C12
  • tridecylic acid CI 3
  • the fatty acid in the antifungal composition is undecylic acid (CI 1), lauric acid (C12), tridecylic acid (C13), myristic acid (CI 4) or corresponding unsaturated fatty acids thereof.
  • the fatty acid in the antifungal composition is formic acid (CI), acetic acid (C2), propionic acid (C3), butyric acid (C4), valeric acid (C5), caproic acid (C6), enanthic acid (C7), caprylic acid (C8), pelargonic acid (C9), capric acid (CIO) or corresponding unsaturated fatty acids thereof.
  • the fatty acid ester in the antifungal composition is selected from the group consisting of ester of formic acid (CI), ester of acetic acid (C2), ester of propionic acid (C3), ester of butyric acid (C4), ester of valeric acid (C5), ester of caproic acid (C6), ester of enanthic acid (C7), ester of caprylic acid (C8), ester of pelargonic acid (C9), ester of capric acid (CI O), ester of undecylic acid (CI 1), ester of lauric acid (CI 2), ester of tridecylic acid (CI 3), ester of myristic acid (C14) and esters of corresponding unsaturated fatty acids thereof.
  • CI ester of formic acid
  • C2 ester of acetic acid
  • C3 ester of butyric acid
  • ester of valeric acid C5
  • ester of caproic acid C6
  • the fatty acid ester in the antifungal composition is selected from the group consisting of propylene glycol monocaprylate, propylene glycol monolaurate, propylene glycol monocaprate, glyceryl monocaprylate, glyceryl monolaurate, glyceryl monocaprate, glyceryl dicapryiate, glyceryl dilaurate, glyceryl dicaprate, glyceryl mono-di caprate, glyceryl mono-di caprylate, glyceryl mono-di laurate, triglycerides of caprylic acid, capric acid, lauric acid and their mixtures, and combinations thereof.
  • the fatty acid ester in the antifungal composition is propylene glycol monocaprylate, propylene glycol monolaurate, glycerol monocaprylate, glycerol monolaurate, or any combination thereof.
  • the antifungal agent of the antifungal composition is selected from the group consisting of allylamines, benzylamines, azoles. polyenes, echinocandins, N -hydroxy pyridone, N- hydroxy pyrithione or metal coordination complexes, tavaborole, flucytosine, griseofulvin, hinokitol and combinations thereof.
  • the N -hydroxy pyridone is piroctone olamine, ciclopirox olamine or a combination thereof;
  • the N-hydroxy pyrithione or the metal coordination complex is zinc pyrithione or any respective bivalent metal co-ordinating complexes or combinations thereof;
  • ailyiamines are selected from the group consisting of terbinafme, amorolfme, naftifine and combinations thereof;
  • the benzylamine is butenafine;
  • the azoles are imidazoles, triazoles or thiazoles selected from the group consisting of ketocoiiazole, climbazole, miconazole nitrate, fluconazole, econazoie, saperconazole, oxiconazoie, clotrimazole, bifonazoie, butoconazole, fenticonazole, isoconazole, omoconazoie, sertaeonazoie, s
  • the excipient in the antifungal composition is selected from the group consisting of additive, solvent, oil, emulsifier, surfactant, stabilizer, cooling agent, preservative, antioxidant, gelling agent, moisturizing agent, emollient, penetration enhancer, colorant, fragrance, pH modifiers, conditioning agent, pearlizing agents, skin barrier repair agents, and combinations thereof.
  • the antifungal composition comprises about 0.01 % to 20% by weight of the antifungal agent.
  • the antifungal composition comprises about 0.01 % to 15% by weight of the antifungal agent.
  • the antifungal composition comprises about 0.01 % to 30% by weight of the saturated or unsaturated fatty acid or ester thereof. In still another embodiment of the present disclosure, the antifungal composition comprises about 0.01 % to 20% by weight of the saturated or unsaturated fatty acid or ester thereof.
  • the antifungal composition comprises about 45% to 99% by weight of the excipient.
  • the antifungal composition comprises about 80% to 99%) by weight of the excipient.
  • the antifungal composition comprises saturated or unsaturated caprylic acid or an ester thereof and antifungal agent selected from the group consisting of allylamines, benzyiarnines, azoles, polyenes, echinocandins, N-hydroxy pyridones, N-hydroxy pyrithiones and combinations thereof, and optionally at least one excipient.
  • the antifungal composition comprises saturated or unsaturated caprylic acid or an ester thereof and antifungal agent selected from the group consisting of terbinafme, butenafine, clotrimazole, lcetoconazole,uciiconazole, bifonazole, efinaconazole, amphotericin B, caspofungin, zinc pyrithione, piroctone Diamine and combinations thereof, and optionally at least one excipient.
  • antifungal agent selected from the group consisting of terbinafme, butenafine, clotrimazole, lcetoconazole,uciiconazole, bifonazole, efinaconazole, amphotericin B, caspofungin, zinc pyrithione, piroctone Diamine and combinations thereof, and optionally at least one excipient.
  • the antifungal composition comprises propylene glycol monocaprylate and antifungal agent selected from the group consisting of aliylamines, benzylamines, azoles, polyenes, echinocandins, N-hydroxy pyridones, N-hydroxy pyrithiones and combinations thereof, and optionally at least one excipient.
  • the antifungal composition comprises propylene glycol monocaprylate and antifungal agent selected from the group consisting of terbinafine, huteiiafme, clotrimazole, ketoconazole, luliconazole, bifonazole, efiiiaconazole, amphotericin B, caspofungin, zinc pyrithione, piroctone olamine and combinations thereof, and optionally at least one excipient.
  • antifungal agent selected from the group consisting of terbinafine, huteiiafme, clotrimazole, ketoconazole, luliconazole, bifonazole, efiiiaconazole, amphotericin B, caspofungin, zinc pyrithione, piroctone olamine and combinations thereof, and optionally at least one excipient.
  • the antifungal composition comprises saturated or unsaturated lauric acid or propylene glycol monolaurate, and antifungal agent selected from the group consisting of aliylamines, benzylamines, azoles, polyenes, echinocandins, N-hydroxy pyridones, N-hydroxy pyrithiones and combinations thereof, and optionally at least one excipient.
  • the antifungal composition comprises saturated or unsaturated lauric acid or propylene glycol monolaurate and antifungal agent selected from the group consisting of terbinafine, butenafme, clotrimazole, ketoconazole, luliconazole, bifonazole, efmaeonazole, amphotericin B, caspofungin, zinc pyrithione, piroctone olamine and combinations thereof, and optionally at least one excipient.
  • antifungal agent selected from the group consisting of terbinafine, butenafme, clotrimazole, ketoconazole, luliconazole, bifonazole, efmaeonazole, amphotericin B, caspofungin, zinc pyrithione, piroctone olamine and combinations thereof, and optionally at least one excipient.
  • the antifungal composition comprises fatty acid ester selected from the group consisting of glyceryl monocaprylate, glyceryl monolaurate, glyceryl monocaprate, glyceryl dicaprylate, glyceryl dilaurate, glyceryl dicaprate, glyceryl mono-di caprate, glyceryl mono-di caprylate and glyceryl mono-di laurate, triglycerides of caprylic acid, capric acid, lauric acid and their mixtures, and antifungal agent selected from the group consisting of aliylamines, benzylamines, azoles, polyenes, echinocandins, N-hydroxy pyridones, N-hydroxy pyrithiones and combinations thereof, and optionally at least one excipient.
  • fatty acid ester selected from the group consisting of glyceryl monocaprylate, glyceryl monolaurate, glyce
  • the antifungal composition comprises fatty acid ester selected from the group consisting of glyceryl monocaprylate, glyceryl monolaurate, glyceryl dicaprylate, glyceryl dilaurate, glyceryl monocaprate, glyceryl dicaprate, glyceryl mono-di caprate, glyceryl mono-di caprylate and glyceryl mono-di laurate, triglycerides of capryiie acid, capric acid, iauric acid and their mixtures, and antifungal agent selected from the group consisting of terbinafine, butenafine, clotrimazole, ketoconazole,iziiconazoie, bifonazoie, efinaconazole, amphotericin B, easpofuiigin, zinc pyrithione, piroctone oiamine and combinations thereof, and optionally at least one excipient
  • the antifungal composition comprises saturated or unsaturated capric acid or an ester thereof and antifungal agent selected from the group consisting of allylamines, benzylamines, azoles, polyenes, echinocandins, N-hydroxy pyridones, N-hydroxy pyrithiones and combinations thereof, and optionally at least one excipient.
  • the antifungal composition comprises saturated or unsaturated capric acid or an ester thereof and antifungal agent selected from the group consisting of terbinafine, butenafine, clotrimazole, ketoconazole, Miconazole, bifonazoie, efinaconazole, amphotericin B, caspofungin, zinc pyrithione, piroctone oiamine and combinations thereof, and optionally at least one excipient.
  • antifungal agent selected from the group consisting of terbinafine, butenafine, clotrimazole, ketoconazole, Miconazole, bifonazoie, efinaconazole, amphotericin B, caspofungin, zinc pyrithione, piroctone oiamine and combinations thereof, and optionally at least one excipient.
  • the antifungal composition comprises saturated or unsaturated undecylic acid or an ester thereof and antifungal agent selected from the group consisting of allylamines, benzylamines, azoles, polyenes, echinocandins, N-hydroxy pyridones, N-hydroxy pyrithiones and combinations thereof, and optionally at least one excipient.
  • the antifungal composition comprises saturated or unsaturated undecylic acid or an ester thereof and antifungal agent selected from the group consisting of terbinafine, butenafine, clotrimazole, ketoconazole, Miconazole, bifonazoie, efmaconazole, amphotericin B, caspofungin, zinc pyrithione, piroctone oiamine and combinations thereof, and optionally at least one excipient.
  • antifungal agent selected from the group consisting of terbinafine, butenafine, clotrimazole, ketoconazole, Miconazole, bifonazoie, efmaconazole, amphotericin B, caspofungin, zinc pyrithione, piroctone oiamine and combinations thereof, and optionally at least one excipient.
  • the antifungal composition comprises (a) piroctone oiamine, propylene glycol monocaprylate and at least one excipient, (b) zinc pyrithione, propylene glycol monocaprylate and at least one excipient, (c) ketoconazole, propylene glycol monocaprylate and at least one excipient, (d) ketoconazole, zinc pyrithione, propylene glycol monocaprylate and at least one excipient, (e) clotrimazole, propylene glycol monocaprylate and at least one excipient, (f) Miconazole, propylene glycol monocaprylate and at least one excipient, (g) terbinafme, propylene glycol monocaprylate and at least one excipient, (h) efmaconazole, propylene glycol monocaprylate and at least one excipient, (i) itraconazole, propylene glycol monocaprylate and at least
  • the antifungal composition comprises (a) piroctone oiamine, glyceryl monocaprylate or glyceryl mono-di caprate or glyceryl mono-di caprylate, and at least one excipient, (b) zinc pyrithione, glyceryl monocaprylate and at least one excipient, (c) ketoconazole, glyceryl monocaprylate and at least one excipient, (d) ketoconazole, zinc pyrithione, glyceryl monocaprylate and at least one excipient, (e) clotrimazole, glyceryl monocaprylate and at least one excipient, (f) Miconazole, glyceryl monocaprylate and at least one excipient, (g) terbinafme, glyceryl monocaprylate and at least one excipient, (h) efmaconazole, glyceryl monocaprylate and at least one excipient, gly
  • the antifungal composition comprises (a) piroctone olamine, undecylenic acid and at least one excipient, (b) zinc pyrithione, undecyienic acid and at least one excipient, (c) ketoconazole, undecylenic acid and at least one excipient, (d) ketoconazole, zinc pyrithione, undecylenic acid and at least one excipient, (e) clotrimazole, undecylenic acid and at least one excipient, (f) Miconazole, undecylenic acid and at least one excipient, (g) terbinafine, undecylenic acid and at least one excipient, (h) efinaconazole, undecylenic acid and at least one excipient, (i) itraconazole, undecylenic acid and at least one excipient, (j) amphotericin B, undecylenic acid and at least one excipient,
  • the antifungal composition comprises (a) piroctone olamine, lauric acid or propylene glycol monolaurate and at least one excipient, (b) zinc pyrithione, lauric acid or propylene glycol monolaurate and at least one excipient, (c) ketoconazole, lauric acid or propylene glycol monolaurate and at least one excipient, (d) ketoconazole, zinc pyrithione, lauric acid or propylene glycol monolaurate and at least one excipient, (e) clotrimazole, lauric acid or propylene glycol monolaurate and at least one excipient, (f) iuliconazole, lauric acid or propylene glycol monolaurate and at least one excipient, (g) terbinafine, lauric acid or propylene glycol monolaurate and at least one excipient, (h) efinaconazole,
  • the antifungal composition is formulated for topical administration, local administration, systemic administration, or any combination thereof.
  • the antifungal composition is formulated into cream, oil, lotion, serum, gel, emugel, hydrogel, shampoo, nail varnish, ointment, foam, spray, aerosol, coating for material selected from surgical implants, silicon tube, catheter, valves, stents, or suture; or any combination of formulations thereof.
  • the present disclosure further relates to a method for treating a fungal infection in a subject in need thereof or managing fungal growth, comprising administering the antifungal composition described herein to the subject, or contacting the antifungal composition described herein with the fungus.
  • the method of treating or managing comprises inhibiting the fungal growth, reducing the fungal growth, eliminating the fungus, curing drug resistant fungal infections, treatment of fungal infections in clinical non-responders and patients with barrier defects, or any combination thereof.
  • the treatment described herein includes medical treatment, cosmetic treatment, or a combination thereof
  • the fractional inhibitoiy concentration (FIC) index of the compositions described herein is less than 1.
  • the fungal infection or fungal growth is caused by fungi selected from the group consisting of Malassezia species, Trichophyton species, Microsporum species, Epidermophyton species, Candida species, Aspergillus species, Cryptococcus species and combinations thereof.
  • the fungal infection or fungal growth is caused by Malassezia spp, selected from the group consisting of M. furfur, M. pachydermatis, M. globosa, M. restricta, M. slooffiae, M. sympodialis, M. nana, M. yamatoensis, M. dermatis, M. obtusa, M. japonica, M. caprae, M. cuniculi, M. equine, and M. arunalokei; Trichophyton spp. selected from the group consisting of 7. rubrum, T mentagrophyte, T inter digitale, T.
  • Malassezia spp selected from the group consisting of 7. rubrum, T mentagrophyte, T inter digitale, T.
  • tonsurans T schoenleinii, T. violaceum, T. ahissinicum, T. halcaneum, T. circonvolutum, T. concentricmn, T eboreum, T. errinacei, T. fischeri, T. fluviomimiense, T glabrum, T. gourvilii, T. kanei, T kuryangei, T. megninii, T. pedis, T. proliferans, T. raubitschekii, T. redellii, T. rodhainii, T. simii, T soudanense, T. thuringien.se, T. verrucosum, T.
  • Candida spp. selected from the group consisting of C. albicans, C glabrata, C. guilliermondii, C. krusei, C. lusitaniae, C. parapsilosis, C. tropica! is, C. colliculosa, C. dubliniensis, C. famata, C haemulonii, C inconspicua, C intermedia, C. kejyr, C. lipolytica, C. rnetapsilosis , C. norvegensis, C. orthopsilosis, C. peUiculosa, C. pulcherrima, C.
  • Microsporum spp. selected from the group consisting of M. audouinii, M. canis, M. amazonicum, M. boullardii, M. cookie, M. distorturn, M. duboisii, M. equinum, M. ferrugineum, M. fulvum, M. gallinae, M. gypseum, M. langeronii, M. nanum, M. persicolor, M. praecox, M, ripariae and M. rivalieri: Epidermophyton spp such as E.
  • floccosum and other non-dermatophytes including but not limited to Aspergillus spp. selected from the group consisting of A, fumigates, A. flavus, A, nidulans, A. terreus, A, lentulus, A, niger, A. alliaceus, A. arvii, A. brevipes, A. calidoustus, A. conjunctus, A. deflectus, A. duricaulis, A. emericeUa, A. fischerian, A. jumigatiaffirus, A. fumisynnematus, A. granulosus, A. novofumigatus, A. panamensis, A.
  • Aspergillus spp. selected from the group consisting of A, fumigates, A. flavus, A, nidulans, A. terreus, A, lentulus, A, niger, A. alliaceus, A. ar
  • Cryptococcus spp. selected from the group consisting of C. neoformans, C. gattii ' , C. alhidus, C. baci ' Ui ' sporus, C. decagatti, C. deiiierogatti, C. lanrentii, C. teiragatti and C. uniguttulatus; or any combination of fungi thereof.
  • the fungus is resistant or susceptible to the antifungal agent comprised in the antifungal composition
  • the subject described herein is mammal including human.
  • the present disclosure also relates to antifungal compositions described herein for use as a medicament.
  • the antifungal compositions described herein are employed for use in treating fungal infection.
  • the present disclosure further relates to use of antifungal compositions described herein for managing fungus growth.
  • the present disclosure further relates to a method of preparing the antifungal compositions described herein, comprising either of:
  • the at least one fatty acid or ester thereof being mixed or added or replaced in the above method has a carbon chain length ranging from C- 11 to C-14, or C-8 to C-10.
  • the concentration of the at least one antifungal agent is about 0.01% to 20%
  • concentration of the at least one fatty acid or ester thereof is about 0.01% to 30%
  • concentration of the one or more excipient is about 45% to 99%, wherein the fatty acid has a carbon chain length ranging from C-l to C-14.
  • the present invention is based in part on inventors' demonstration that medium carbon chain fatty' acids and/or esters thereof unexpectedly and surprisingly show synergistic effects in antifungal activity when combined with various antifungal agents. Further, medium chain fatty acids and esters in combination with various antifungal agents also demonstrate synergistic antifungal activity against both drug susceptible and resistant fungi (known to be resistant against the particular antifungal agent). Accordingly, the present invention is directed to antifungal compositions for the management of fungal growth or treatment of fungal infections, including resistant fungal infections, wherein the composition comprises of: (i) at least one antifungal agent; and (ii) at least one medium carbon chain fatty acid or ester thereof; these two components being synergistic in their antifungal activity.
  • a fractional inhibitory concentration (FIC) index of the tested combinations of antifungal agents and the medium carbon chain fatty acid or ester thereof is less than 1 establishing the synergy of the present compositions.
  • the antifungal composition comprises at least one antifungal agent, at least one fatty acid or ester thereof having carbon chain length ranging from C-l to C-14, and at least one excipient wherein the antifungal agent and medium chain fatty acid or ester thereof have been shown to be synergistic in their antifungal activity.
  • the antifungal composition wherein the antifungal agent and medium chain fatty acid or ester thereof have been shown to be synergistic in their antifungal activity further comprises at least one oil (excipient).
  • methods of preparing the antifungal compositions which includes preparing said compositions by: (i) mixing individual components or their respective solutions in any order viz. at least one antifungal agent, at least one fatty acid or ester thereof having carbon chain length ranging from C-l to C-14 and optionally at least one excipient; (ii) employing existing/known antifungal based compositions and modifying the same to obtain the present compositions.
  • Yet another aspect of the present invention is to provide methods for the treatment of fungal infections comprising administering to a subject in need thereof, an antifungal composition of the present invention, in some embodiments, the fungal infection is a resistant fungal infection which is treated by the compositions of the present invention.
  • the term “synergistic” or “synergy” means that the antifungal effect achieved with combinations of antifungal agents and medium carbon chain fatty acids/esters is greater than the sum of the effects that results from using the anti-fungal agent and said fatty acid/ester individually.
  • “synergy” is being achieved by the combination of antifungal agents and medium carbon chain fatty acids/esters, a term, which is therefore also applicable to compositions comprising the said combinations, with or without any additional component.
  • the terms “synergistic antifungal composition”, “synergistic combination”, “synergistic antifungal combination” or “synergistic composition” may be used interchangibly in the present disclosure and refer to the compositions/combinations of the disclosure comprising at least one antifungal agent, at least one fatty acid or ester thereof, and with/without excipient(s)/additional agent(s).
  • the present disclosure also similarly provides for the "antifungal composition” of the present disclosure, having an antifungal activity, wherein such antifungal activity is synergistic antifungal activity. The synergy is measured by determining the fractional inhibitory concentration (FIC) value of the combination.
  • FIC fractional inhibitory concentration
  • test agent 1 is serially diluted through the wells horizontally (left to right) and test agent 2 is serially diluted through the wells vertically down. No agent is added to the penultimate column on the right and the bottom row. The final column on the right is used for growth control (only inoculum in broth) and sterility control (broth alone, no inoculum).
  • Inoculum of relevant fungal strain were added to the wells with various drug combinations and observed for growth inhibition at the end of the incubation period set by protocol. For any combination wherein growth inhibition was observed at concentrations below the individual MICs of each agent, calculations were performed to determine the fractional inhibitory concentration. FIC value for each agent in a particular well of the checkerboard layout was calculated by dividing the agent concentration in that well by the established MIC value of the agent against the test organism (Hsieh et al, Synergy assessed by checkerboard: A critical Analysis, Diagn. Microbiol. Infect Dls. (1993) 16:343-349).
  • FIC values for both agents in a particular well were calculated in this way followed by determination of the FIC index (sum of the FICs of each drug in the concerned well). Combinations that gave FIC indices less than 1 are designated as "synergistic" based on the guidelines from the literature [Zhang et al , Synthesis of novel sulfonamide azoles via C-N cleavage of sulfonamides by azole ring and relational antimicrobial study. New J Chan, (2015) 39:5776-5796 and Meletiadis et al, Defining Fractional Inhibitory Concentration Index Cutoffs for Additive Interactions based on self-drug combinations, Antimicrob. Agents Chemother, (2010) 54(2): 602-609].
  • Antifungal agent as used herein includes, but is not limited to N-hydroxy pyridone class like piroctone olamine, ciclopirox olamine; imidazoles like ketoconazole, climbazole, miconazole nitrate, fluconazole, econazole, saperconazole, oxiconazole, clotrimazole, bifonazole, butoconazole, fenticonazole, isoconazole, omoconazoie, sertaconazole, sulconazoie, tioconazole, Miconazole, chlormidazole, eroeonazoie, eberconazole, omoconazoie, isoconazole, neticonazole; triazoles like albaconazole, efinaconazole, fosfluconazole, epoxicoriazole, fluconazole, isavuconazole, itraconazole,
  • the medium carbon chain fatty acids includes saturated or mono, di or poly unsaturated C-l to C-14 (also interchangeably referred as CI to C14) fatty acids, including propionic acid (propanoic acid), butyric acid (butanoic acid), valeric acid (pentanoic acid), caproic acid (hexanoic acid), enanthic acid (heptanoic acid), caprylic acid (octanoic acid), pelargonic acid (nonanoic acid), capric acid (decanoic acid), undecyiic acid (undecanoic acid), lauric acid (dodecanoic acid), tridecylic acid (tridecanoic acid) and myristic acid (tetradecanoic acid), and esters/derivatives of said saturated or mono, di or poly unsaturated C-1 to C-14 fatty acids thereof including but not limited to mono, di and tri-esters of propylene glycol and glycerol and their derivative
  • the saturated or unsaturated medium chain fatty acid having carbon chain length ranging from C-1 to C-14 is caprylic acid, undecylenic acid, lauric acid, their esters, or any combinations thereof.
  • the saturated or unsaturated medium chain fatly acid esters/derivatives having carbon chain length ranging from C-i to C-14 is a mono, di or tri ester of glycerol, propylene glycol and derivatives, or any combinations thereof.
  • the exemplary saturated or unsaturated medium chain fatty acids and their esters show synergistic behavior with the antifungal agents.
  • the antifungal agent is selected from a group comprising allylamme class of antifungal agents, benzyl amine class of antifungal agents, azole class of antifungal agents, echinocandin class of antifungal agents, polyene class of antifungal agents, N- hydroxy pyridone class of antifungal agents, N-hydroxy pyrithione like zinc pyrithione, and any combinations thereof, with the said medium chain fatty acids/esters thereof.
  • excipient or “excipients” in the present compositions/formulations refer to other ingredient(s)/component(s) excluding the antifungal agent and fatty acids or their esters described herein.
  • excipient includes classes selected from but not limited to additives, solvents, oils, emulsifiers, surfactants, polymers, stabilizers, other active agent(s) and any combinations thereof. Exemplary examples of the excipients are described throughout the disclosure. Further, any excipient generally known in the art for pharmaceutical or cosmetic applications is within the purview of the present disclosure/compositions/formulations.
  • the excipients in some embodiments are selected from a group comprising paraffin, thickeners selected from bentonite and cellulose, antioxidants selected from butylated hydroxyanisole (BHA), tert-butylhydroquinone (TBHQ), ferulic acid, tocopherol acetate or any combination of antioxidants thereof, perfumes or fragrances, essential oils, pH adjusters selected from triethanolamine, sodium hydroxide, inorganic or organic acids including citric acid, lactic acid, succinic acid, acetic acid, fumaric acid, glycoiic acid, benzoic acid, bases, salts buffers or any combination of pH adjusters thereof, herbal extracts selected from amla fruit extract, arnica extract and brahmi extract, preserving agents selected from butylated hydroxytoluene (BHT), methyl p-hydroxybenzoate, propyl p-hydroxybenzoate, sorbic acid or any combination of preserving agents thereof, hair conditioning substances, hair care adjuncts selected from taurine, caffeine, min
  • the antifungal compositions can be obtained/formulated in any form.
  • the present the antifungal compositions are in typical particle form, solubilized form, dispersed form, iianoparticle form or any combination thereof. It is to be understood that the present antifungal compositions are not limited by any particular form and all forms of the composition is within the scope of the present invention.
  • the antifungal agent in the present compositions is selected from a group comprising zinc pyrithione, piroctone oiamine, terbinafine, butenafme, clotrimazole, ketoconazole, efinaconazole, luliconazole, bifonazole, caspofungin, amphotericin B and any combinations thereof.
  • the present disclosure specifically addresses the need of the art by providing antifungai/antimicrobial compositions which does not enhance fungal growth/infection, and synergistically improves fungal growth inhibition/treatment of fungal infection.
  • Said antifungai/antimicrobial compositions are specifically devoid of long chain C-15 or greater fatty acids or their esters which are shown as promoters of fungal growth.
  • the present invention is directed to a variety of antifungal formulations comprising at least one antifungal agent described herein and at least one medium carbon chain fatty acid (C-1 to C-14) or ester thereof, with/without excipient(s).
  • the present invention is further directed to a variety of antifungal formulations comprising at least one antifungal agent described herein and at least one medium carbon chain fatty acid C-1 1 to C-14 or ester thereof, with/without excipient(s).
  • the present invention is also directed to a variety of antifungal formulations comprising at least one antifungal agent described herein and at least one medium carbon chain fatty acid of C-1 to C-10 or ester thereof, with/without excipient(s).
  • the present invention further provides antifungal formulations comprising at least one antifungal agent described herein described herein and at least one C-8 fatty acid or ester thereof, with/without excipient(s).
  • antifungal formulations comprising one or more antifungal agents described herein and propylene glycol monocaprylate, with/without excipient(s) is provided.
  • antifungal formulations are provided comprising one or more antifungal agents described herein along with caprylic acid, with/without excipient(s).
  • antifungal formulations are provided comprising one or more antifungal agents described herein and propylene glycol monolaurate, with/without excipient(s).
  • the antifungal agent used in the composition of the present invention is piroctone ol amine.
  • the antifungal agent is ketoconazole.
  • the composition comprises a combination of piroctone olamine and ketoconazole.
  • the antifungal agent used in the composition of the present invention is zinc pyrithione.
  • the composition comprises a combination of zinc pyrithione and ketoconazole.
  • the anti-dandraff/anti-fungal agents of the present compositions include ketoconazole, climbazole, selenium sulfide, piroctone olamine, ciclopirox olamine, zinc pyrithione, or any combinations thereof wherein said antifungal agent may be present in the solubilized form or dispersed form or in the particle or nanoparticle form.
  • Other anti-fungal agents from similar class are known to the art may also be used in the formulation.
  • the antifungal agent used in the composition of the present invention is ketoconazole.
  • the antifungal agent used in the composition of the present invention is clotrimazole.
  • the antifungal agent used in the composition of the present invention is Miconazole.
  • the antifungal agent used in the composition of the present invention is efinaconazole. In one embodiment, the antifungal agent used in the composition of the present invention is bifonazole.
  • the antifungal agent used in the composition of the present invention is terbinafine.
  • the present disclosure also provides shampoo formulations containing antifungal agent and medium carbon chain fatty acids or esters described herein along with excipient selected from at least one, two or more anti-dandruff agents, at least one or two oil components, viscosity modifiers, conditioning agent, stabilizers, emulsifiers and surfactants selected from the group of mild sulfate or sulfate free or combinations of anionic and zwitterionic or anionic and neutral or anionic, neutral and zwitterionic surfactants that can form structured multilamellar liquid surfactant system that can deform to form muiti lamellar vesicles/spheralites when sheared or diluted.
  • excipient selected from at least one, two or more anti-dandruff agents, at least one or two oil components, viscosity modifiers, conditioning agent, stabilizers, emulsifiers and surfactants selected from the group of mild sulfate or sulfate free or combinations of anionic and
  • the shampoo compositions of the present discl osure is used for the treatment of seborrheic dermatitis.
  • the shampoo compositions of the present invention may further contain excipients including additives known in the art.
  • the shampoo compositions may comprise excipients selected from preservatives, perfumes, pH adjusting agents, colorants one or more viscosity modifiers, humectants, conditioners, bactericides, surfactants etc.
  • the shampoo composition may further contain alcohols, ketones and other solvents or herbal extracts, fruit extracts, vitamins, pigments.
  • the surfactant includes sulfate free surfactants selected from a group comprising coco glucoside, iauryl glucoside, decyl glucoside, capryiyl capryl glucoside, sodium cocoyl glutamate, disodium cocoyi glutamate, sodium lauroamphoacetate, sodium cocoamphoacetate, disodium cocoamphoacetate, disodium laureth sulfosuccinate, sodium methyl cocoyl taurate, sodium methyl oleoyi taurate, sodium cocoyl isethionate, ammonium cocoyl isethionate, sodium Iauryl glucose carboxylate, sodium lauroyl lactylate, sodium lauroyl sarcosinate, sodium lauroyl methyl isethionate, sodium cocoyl glycinate and others surfactants as known in the art.
  • sulfate free surfactants selected from a group comprising coco glucoside, iauryl glucoside
  • the surfactant includes mild surfactants that can form structured multilamellar liquid surfactant system which deform to form multi lamellar vesicles/spherulites when sheared can be used.
  • surfactant includes an individual surfactant or a blend of various surfactants in right proportion.
  • surfactant and co-surfactant blends include Iseiux SLC (sodium lauroyl methyl isethionate, sodium lauroamphoacetate, cocamide MIPA and water) and Miracare SLB 365/N (sodium trideceth sulfate, sodium lauroamphoacetate, cocamide MEA, sodium Chloride, methylisothiazolinone and water) where combination of different surfactants at particular ratios in the presence of particular concentration of electrolyte is responsible for formation of structured multilamellar liquid surfactant system that helps in dispersing and stabilizing high levels of oil, fragrance and different high density particles such as mica, pigments, zinc pyrithione, selenium sulfide etc. into the formulation.
  • Structured surfactant system provides excellent stability of the formulation over wide temperature range while retaining good foaming performance in the presence of oil and improved persistence of fragrance on hair and skin while maintaining high conditioning performance.
  • the present invention particularly describes ketoconazole, clotrimazole, Miconazole, efinaconazole, bifonazole and terbinafine based topical cream or gel or emuigel or lotion formulations containing at least one fatty acid having carbon chain length of C-l to C-l 4 or ester thereof, along with excipients selected from at least one or two oil components, surfactants, co- surfactants, viscosity modifiers or gelling agents, emollients, skin penetrating agents, conditioning agents, stabilizers, emollients to finally obtain spreadable stable topical formulations.
  • the pH of the formulation is adjusted by suitable pH modifier to maintain final pH of 5-7 and preferably pH 6-7.
  • API antifungal agent
  • the medium chain fatty acid or ester thereof is either completely solubilized form or present in oil globules with particular size distribution ranges from 100-1000 nm, and preferably 100-500 ran that would help better absorption of the active through skin to achieve improved pharmacokinetics and pharmacodynamics.
  • the topical formulations including cream, gel or lotion is used for the diagnosis and management of various skin fungal infections/fungal growth caused by but not limited to pathogens including Malassezia, Candida and dermatophytes such as Trichophyton wherein the fatty acid or esters thereof in said composition is restricted to saturated or unsaturated medium chain fatty acids (CI to C14), esters and derivatives thereof.
  • the fatty acid is a molecule having a carbon chain length of CI 1 to CI 4, or corresponding esters and/or derivatives thereof.
  • the fatty acid is a molecule having a carbon chain length of CI to CIO, or corresponding esters and/or derivatives thereof.
  • the fatty acid is a molecule having a carbon chain length of C8, or corresponding esters and/or derivatives thereof.
  • the compositions of the present disclosure include one or more fatty acid selected from eaprylic acid, capric acid, undecvlenic acid, lauric acid and the respective mono/di and tri ester derivatives of propylene glycol and glycerol.
  • the percentage of fatty acids and/or corresponding esters or derivatives in the composition ranges from 1-10%, and depending on the oil percentage the concentration of the excipients including surfactants, co-surfactants and emulsifiers vary to finally obtain hydrophobic lipophilic balanced (HLB) stable formulations.
  • HLB hydrophobic lipophilic balanced
  • Gelling agent can be selected from carbopol or hydroxy ethyl cellulose (HEC) or any other known agent, or any combinations thereof within the concentration ranges from 0.05-1 % and more preferably 0.05-0.5%.
  • Miconazole is present along with medium chain fatty acids and/or corresponding esters or derivatives in completely solubilized form in the form of lotion wherein the said active is stabilized by particular concentration of surfactants, co- surfactants, emulsifiers, stabilizing agent and emollients to form transparent to opaque lotion and preferably transparent formulation.
  • composition is either devoid of alcohol or with minimum percentage of alcohol ranging from 1-20%, and more preferably 1-10% along with other soiubilizers like 1,3 -propanediol or diethylene glycol mono ethyl ether or diisopropyl adipate or any other solubilizer at particular ratios to finally obtain either water based or oil based transparent to opaque, and preferably transparent stable topical lotion.
  • soiubilizers like 1,3 -propanediol or diethylene glycol mono ethyl ether or diisopropyl adipate or any other solubilizer at particular ratios to finally obtain either water based or oil based transparent to opaque, and preferably transparent stable topical lotion.
  • luliconazole and efinaconazole along with medium chain fatty acids and/or corresponding esters or derivatives based nail lacquer or nail solution are made for the treatment or management of onychomycoses.
  • the nail lacquer of the present invention forms a transparent solution including an organic film former which in general any kind of biocompatible organic solvents that upon application to the nails, evaporate, leaving a relatively water permeable film.
  • the amount of solvent in the nail lacquer or solution composition of the present invention is sufficient to solubilize and dissolve the film-forming compounds as well as the active (antifungal agent) at a particular concentration.
  • the solvents include alcohol, butyl acetate, ethyl acetate or any other solvents known in the prior art.
  • Film- forming compounds include polymers and copolymers of vinyl acetate, polymers and copolymers of acrylic or methacrylic acid (e.g., polymethyl methacryiate) polyvinylacytel and polyviiiylbutyrals.
  • the piasticizers like triacetin or any other known in the art can be employed.
  • the above composition is used for the treatment of Candida and various tinea infections wherein said composition is restricted to saturated or unsaturated medium chain fatty acids, esters and derivatives thereof as described above.
  • such medium chain fatty acids are selected from caprylic acid, capric acid, undecylenie acid, iauric acid and the respective mono/di and tri ester derivatives of propylene glycol and glycerol.
  • the amount of antifungal agent(s) used in the compositions of the present invention is in the range of from about 0.01% to 20% by weight of the total composition. In one embodiment, the antifungal agent is in the range from about 0.01 % to about 10% by weight of the total composition. In a further embodiment, the antifungal agent is in the range of from about 0.01 % to about 5% by weight of the total composition. In yet another embodiment, the antifungal agent is in the range of about 0.01 % to about 2% by weight of the total composition.
  • excipient includes, but is not limited to, solvents, surfactants and additives used in pharmaceutical and cosmetic formulations.
  • the amounts of excipients used in the compositions of the present invention is in the range of about 45 % to about 99% by weight of the total composition.
  • the excipient is an oil and includes, but is not limited to, paraffin oil, silicone oils, terpenes, fatty alcohols, dibutyi adipate, dioctyi adipate, or any combination of oils thereof.
  • Essential oils as used herein include, but are not limited to, natural and synthetic oils such as eucalyptus oil, rosemary oil, pine needle oil, tea tree oil, sage oil, cinnamon oil, lemon oil, citronelfa oil, lime oil, orange oil, peppermint oil, spearmint oil, wintergreen oil, sweet birch oil, clove leaf oil, camphor oil, cardamon oil, cedar leaf oil, sweet birch oil and other oils known to a skilled person in the art.
  • the amount of oil used in the compositions of the present invention is in the range of about 0.5% to about 99% by weight of the total composition, more preferably 50% to 99% when formulated as oil, 5%> to 50% when formulated as cream/ointment or 0.5% to 20% when formulated as gel/serum/spray.
  • excipient is solvent and includes, but is not limited to, lower aliphatic alcohols, such as, for example, ethanol, isopropyl alcohol, butanol and the likes, lower aikyl acetate, ethers, fatty alcohols such as undecanol, oleyl alcohol, lauryl alcohol or combinations thereof.
  • lower aliphatic alcohols such as, for example, ethanol, isopropyl alcohol, butanol and the likes, lower aikyl acetate, ethers, fatty alcohols such as undecanol, oleyl alcohol, lauryl alcohol or combinations thereof.
  • excipient is additive and includes, but is not limited to, thickeners, antioxidants, perfumes/fragrances, essential oils, pH adjusters, herbal extracts, preserving agents, hair conditioning substances, hair care adjuncts, skin care adjuncts, emollient, dyestuffs, moisturizers, vitamins, sphingoceryls, sunscreens, surfactants, oil-soluble polymers which are compatible with the base oil and/or skin care agents including skin-nutrient agents, anti-wrinkle agents, light and dust protectors, or any combination of additives thereof.
  • compositions of the present invention may contain additives such as thickeners (for example, bentonite, cellulose and the like), antioxidants (for example, butylated hydroxytoluene (BHT), butylated hydroxyanisole (BHA), tert-butylhydroquinone (TBHQ), ferulic acid, vitamin A, vitamin E (tocopherol)), preservatives (for example, methyl p-hydroxybenzoate or propyl p- hydroxybenzoate, sorbic acid and the like), hair care ingredients (for example, fatty alcohols, peptides, proteins, vitamins and mixtures thereof), light protective agents or sunscreens (for example, p-methoxycinamic acid isoamyl ester and the likes).
  • thickeners for example, bentonite, cellulose and the like
  • antioxidants for example, butylated hydroxytoluene (BHT), butylated hydroxyanisole (BHA), tert-butylhydroquinon
  • the excipient is surfactant and includes, but are not limited to, cetearths, ceteth, isoceteths, iaureths, oleths, steareths, lauramide DEA, iinoieamide DEA and other surfactants which are suitable for topical application.
  • the pH adjusters include, but are not limited to, inorganic or organic acids (e.g., citric acid, lactic acid, succinic acid, acetic acid, fumaric acid, glycolic acid, benzoic acid), bases, salts and/or buffers thereof, in an embodiment, the herbal extracts as used herein include, but are not limited to, amla fruit extract, arnica extract, brahmi extract and others known to the art-skilled.
  • inorganic or organic acids e.g., citric acid, lactic acid, succinic acid, acetic acid, fumaric acid, glycolic acid, benzoic acid
  • bases salts and/or buffers thereof
  • the herbal extracts as used herein include, but are not limited to, amla fruit extract, arnica extract, brahmi extract and others known to the art-skilled.
  • the hair care adjuncts as used herein include, but are not limited to, ingredients beneficial in the treatment of hair loss or the promotion of hair growth such as taurine, caffeine, minoxidil, azelaic acid, marine cartilage, hydrolysed keratin, biotin, niacin, panthenol, vitamin B6, zinc, copper, peptides, horsetail silica, beta sitosterols, pycnogeiiol, PABA, green tea extract, folic acid, iron, L-cysteine, magnesium, ginseng and others known to the art-skilled.
  • ingredients beneficial in the treatment of hair loss or the promotion of hair growth such as taurine, caffeine, minoxidil, azelaic acid, marine cartilage, hydrolysed keratin, biotin, niacin, panthenol, vitamin B6, zinc, copper, peptides, horsetail silica, beta sitosterols, pycnogeiiol, PABA,
  • the skin care adjuncts as used herein include, but are not limited to, those that are beneficial for the treatment of various skin conditions (like dry skin, oily skin, fine lines, pigmentation, etc.) such as proteins, vitamins (e.g., A, B, C, D, E, and K), trace metals (e.g., zinc, calcium and selenium), moisturizers (e.g., emollients, humeetants, film formers, occlusive agents, and agents that affect the natural moisturization mechanisms of the skin), LTV absorbers (physical and chemical absorbers such as paraminobenzoic acid (PABA), titanium dioxide, zinc oxide, etc.), anti-irritants (e.g., steroids and non-steroidal anti-inflammatories), botanical extracts (e.g., aloe vera, chamomile, cucumber extract, ginkgo biioba, ginseng, and rosemary), absorbents (e.g., aluminum starch octenylsuccin, a
  • Another embodiment of the present invention provides use of the antifungal compositions described herein as a medicament, more particularly for managing fungal growth or treating fungal infections and associated complications/conditions therein.
  • the terms “manage”, “managing”, “management”, “treat”, “treating” or “treatment” of fungus growth or fungus infection refers to both medical or non-medical indications. In one aspect, these terms cover one or more aspects including but not limiting to preventing or reducing growth of fungi, inhibiting further growth of fungi, eliminating the grown fungi at the infected area/site, providing symptomatic relief to a subject in need thereof, successfully eliminating the infection, curing the fungal infection, preventing recurrence of fungal infection, curing drag resistant fungal infections, and treatment of fungal infections in clinical non-responders and patients with barrier defects.
  • the antifungal compositions of the present invention achieves one or more of the above described effects, and includes any additional effects/activity known to a person skilled in the art.
  • the above terms cover any antifungal treatment in a mammal, including human.
  • Yet another embodiment of the present invention provides methods for the treatment of fungal infections comprising administering to a subject/patient in need thereof an antifungal composition of the present invention.
  • the fungal infection is a resistant fungal infection.
  • the fungal infection is resistant to the antifungal agent or class of antifungal agents included in the antifungal composition comprising the said antifungal agent and a medium chain fatty acid or its ester that show synergistic antifungal activity for treatment of the said resistant fungal infection.
  • the antifungal compositions of the present invention are used in the treatment of diseases associated with, including but not limited to, Ma!assezia spp. (e.g., M. furfur, M. pachydermatis, M. globosa, M.
  • Trichophyton spp. e.g., T rubrum, T mentagrophyte, T inter digitale, T. tonsurans, T schoenleinii, T. violaceum, T. abissinicum, T. balcaneum, T. circonvolutum, T. concentricum, T. eboreum, T.
  • compositions of the present invention are intended for use in the treatment of diseases including but not limited to tinea pedis, tinea capitis, tinea cruris, tinea giabrosa, tinea corporis, tinea unguium, tinea faciei, tinea manuum, piedra, pityriasis capitis, pityriasis vesicolor, pityrosporum folliculitis, seborrheic dermatitis, diaper rash, scalp seborrheic dermatitis, cutaneous candidiasis, onychomycosis, Candida folliculitis, skin fungal infections associated with barrier defects as in atopic dermatitis, xerotic eczema and psoriasis, otomycosis, mucosal candidiasis and deep tissue infections including but not restricted to biofilm forming/n
  • compositions of the present invention are also of veterinary use in the topical treatment of dermatological fungal infections.
  • compositions of the present invention provide better retention and penetration of antifungal agent onto the hair, skin, scalp and nails. Accordingly, the present invention provides compositions and methods of managing fungus growth or treating fungal infections of the skin, scalp, hair or nail.
  • the antifungal composition is topical hair oil.
  • the antifungal composition of the present invention is anti-dandruff oil.
  • the composition of the present invention is a hair gel.
  • the antifungal composition of the present invention is anti-dandruff shampoo.
  • the antifungal composition of the present invention is anti- dandruff hair serum.
  • the composition of the present invention is a nail varnish.
  • compositions of the present invention is employed for the purpose of topical and/or local administration in the form of oils, creams, lotions, serums, gels, ointments, foams, sprays, aerosols, coating on implants, silicon tubes, catheters, sutures and the likes.
  • the synergistic combination of the present invention comprises caprylic acid or its ester derivatives with an antifungal agent selected from a group comprising ailylamine class of antifungal agents, benzylamine class of antifungal agents, azole class of antifungal agents, echinocandin class of antifungal agents, polyene class of antifungal agents, N-hydroxy pyridone class, N-hydroxy pyrithione like zinc pyrithione, and selenium sulfide, or any combinations thereof.
  • an antifungal agent selected from a group comprising ailylamine class of antifungal agents, benzylamine class of antifungal agents, azole class of antifungal agents, echinocandin class of antifungal agents, polyene class of antifungal agents, N-hydroxy pyridone class, N-hydroxy pyrithione like zinc pyrithione, and selenium sulfide, or any combinations thereof.
  • the synergistic combination of the present invention comprises undecylenic acid with an antifungal agent selected from a group comprising ailylamine class of antifungal agents, benzylamine class of antifungal agents, azole class of antifungal agents, echinocandin class of antifungal agents, polyene class of antifungal agents, N-hydroxy pyridone class, N-hydroxy pyrithione like zinc pyrithione, and selenium sulfide, or any combinations thereof.
  • an antifungal agent selected from a group comprising ailylamine class of antifungal agents, benzylamine class of antifungal agents, azole class of antifungal agents, echinocandin class of antifungal agents, polyene class of antifungal agents, N-hydroxy pyridone class, N-hydroxy pyrithione like zinc pyrithione, and selenium sulfide, or any combinations thereof.
  • the synergistic combination of the present invention comprises lauric acid or its ester derivative with an antifungal agent selected from a group comprising ailylamine class of antifungal agents, benzylamine class of antifungal agents, azole class of antifungal agents, echinocandin class of antifungal agents, polyene class of antifungal agents, N-hydroxy pyridone class, N-hydroxy pyrithione like zinc pyrithione, and selenium sulfide, or any combinations thereof.
  • an antifungal agent selected from a group comprising ailylamine class of antifungal agents, benzylamine class of antifungal agents, azole class of antifungal agents, echinocandin class of antifungal agents, polyene class of antifungal agents, N-hydroxy pyridone class, N-hydroxy pyrithione like zinc pyrithione, and selenium sulfide, or any combinations thereof.
  • compositions of the present disclosure comprising medium chain fatty acids/esters thereof with antifungal agents which impart synergistic antifungal activity
  • the compositions of the present disclosure are devoid of C-l 5 or greater fatty acids and/or esters thereof.
  • the compositions of the present disclosure comprise C-l to C-14 fatty acids and/or esters thereof, in exemplary embodiments, compositions of the present disclosure comprise C-l 1 to C- 14 fatty acids and/or esters thereof, and are devoid of C-15 or greater fatty acids and/or esters thereof.
  • the compositions of the present disclosure comprise C-l to C-10 fatty acids and/or esters thereof, and are devoid of C- 15 or greater fatty acids and/or esters thereof.
  • the compositions of the present disclosure comprise C-8 fatty acid and/or esters thereof, and are devoid of C- 15 or greater fatty acids and/or esters thereof.
  • the compositions of the present disclosure comprise C-l 2 fatty acid and/or esters thereof, and are devoid of C-15 or greater fatty acids and/ or esters thereof.
  • the antifungal composition comprises caprylic acid or caprylic acid esters and an antifungal agent selected from various classes comprising allylamines, benzylamines, azoles, echinocandins, polyenes, N-hydroxy pyridones, N-hydroxy pyrithione like zinc pyrithione and selenium sulfide, and or any combinations thereof, wherein the composition is devoid of C- 15 or greater fatty acids and/or esters thereof.
  • the antifungal composition comprises propylene glycol monocaprylate (caprylic acid ester) and an antifungal agent selected from various classes comprising allylamines, benzylamines, azoles, echinocandins, polyenes, N-hydroxy pyridones, N-hydroxy pyrithione like zinc pyrithione and selenium sulfide, or any combinations thereof, wherein the composition is devoid of C-15 or greater fatty acids and/or esters thereof.
  • an antifungal agent selected from various classes comprising allylamines, benzylamines, azoles, echinocandins, polyenes, N-hydroxy pyridones, N-hydroxy pyrithione like zinc pyrithione and selenium sulfide, or any combinations thereof, wherein the composition is devoid of C-15 or greater fatty acids and/or esters thereof.
  • the antifungal composition comprises glyceryl monocaprylate (caprylic acid ester) and an antifungal agent selected from various classes comprising allylamines, benzylamines, azoles, echinocandins, polyenes, N-hydroxy pyridones, N-hydroxy pyrithione like zinc pyrithione and selenium sulfide, or any combinations thereof, wherein the composition is devoid of C-15 or greater fatty acids and/or esters thereof.
  • an antifungal agent selected from various classes comprising allylamines, benzylamines, azoles, echinocandins, polyenes, N-hydroxy pyridones, N-hydroxy pyrithione like zinc pyrithione and selenium sulfide, or any combinations thereof, wherein the composition is devoid of C-15 or greater fatty acids and/or esters thereof.
  • the antifungal composition comprises undecylenic acid and an antifungal agent selected from various classes comprising ailylamines, benzylamines, azoles, echinocandins, polyenes, N-hydroxy pyridones, N-hydroxy pyrithione like zinc pyrithione and selenium sulfide, or any combinations thereof, wherein the composition is devoid of C-15 or greater fatty acids and/or esters thereof.
  • an antifungal agent selected from various classes comprising ailylamines, benzylamines, azoles, echinocandins, polyenes, N-hydroxy pyridones, N-hydroxy pyrithione like zinc pyrithione and selenium sulfide, or any combinations thereof, wherein the composition is devoid of C-15 or greater fatty acids and/or esters thereof.
  • the antifungal composition comprises lauric acid or lauric acid ester and an antifungal agent selected from various classes comprising ailylamines, benzylamines, azoles, echinocandins, polyenes, N-hydroxy pyridones, N-hydroxy pyrithione like zinc pyrithione, selenium sulfide and any combinations thereof, wherein the composition is devoid of C-15 or greater fatty acids and/or esters thereof.
  • an antifungal agent selected from various classes comprising ailylamines, benzylamines, azoles, echinocandins, polyenes, N-hydroxy pyridones, N-hydroxy pyrithione like zinc pyrithione, selenium sulfide and any combinations thereof, wherein the composition is devoid of C-15 or greater fatty acids and/or esters thereof.
  • the antifungal composition comprises propylene glycol monolaurate (lauric acid ester) and an antifungal agent selected from various classes comprising ailylamines, benzylamines, azoles, echinocandins, polyenes, N-hydroxy pyridones, N-hydroxy pyrithione like zinc pyrithione and selenium sulfide, or any combinations thereof, wherein the composition is devoid of C- 15 or greater fatty acids and/or esters thereof.
  • an antifungal agent selected from various classes comprising ailylamines, benzylamines, azoles, echinocandins, polyenes, N-hydroxy pyridones, N-hydroxy pyrithione like zinc pyrithione and selenium sulfide, or any combinations thereof, wherein the composition is devoid of C- 15 or greater fatty acids and/or esters thereof.
  • the antifungal composition comprises glyceryl monolaurate (lauric acid ester) and an antifungal agent selected from various classes comprising ailylamines, benzylamines, azoles, echinocandins, polyenes, N-hydroxy pyridones, N-hydroxy pyrithione like zinc pyrithione and selenium sulfide, or any combinations thereof, wherein the composition is devoid of C- 15 or greater fatty acids and/or esters thereof.
  • an antifungal agent selected from various classes comprising ailylamines, benzylamines, azoles, echinocandins, polyenes, N-hydroxy pyridones, N-hydroxy pyrithione like zinc pyrithione and selenium sulfide, or any combinations thereof, wherein the composition is devoid of C- 15 or greater fatty acids and/or esters thereof.
  • compositions of the invention in addition to being highly effective against drug susceptible fungi, are particularly useful for treatment of resistant fungal infections.
  • the compositions of the invention are particularly useful for treatment of antifungal infections which are resistant to one or more conventional drags used for treatment of fungal infections.
  • the compositions of the invention are particularly useful for treatment of fungal infections which are resistant to azoles, allylamines and benzylamines.
  • the invention provides an antifungal composition for treatment of resistant fungal infection(s) comprising at least one antifungal agent and at least one fatty acid having carbon chain length of C-1 to C-14 or ester thereof, wherein said composition shows in vitro synergistic antifungal activity'.
  • the fungus associated with the infection is resistant to the antifungal agent or class of antifungal agent comprised in the antifungal composition. Accordingly, the present compositions are devised such that antifungal agent along with at least one medium chain fatty acid (C-1 to C-14) or ester thereof provides successful activity/treatment of the said resistant fungal infection.
  • C-1 to C-14 medium chain fatty acid
  • the antifungal composition for treatment of resistant fungi infection(s) comprises at least one antifungal agent and at least one fatty acid or ester thereof having carbon chain length ranging from C-1 to C-14 (the combination of the antifungal agent and fatty acid or ester showing in vitro synergistic antifungal activity), and at least one excipient.
  • the at least one fatty acid or ester thereof has a carbon chain length ranging from C-11 to C-14, or C-i to C-10, or C-8, or C-11, or C-12, or C-13, or C-14, or any combination thereof.
  • the composition is devoid of C-15 or greater fatty acids and esters.
  • the antifungal composition for treatment of resistant fungal infection(s) comprises at least one antifungal agent and at least one fatty acid or ester thereof having carbon chain length ranging from C- 1 to C- 10 (the combination of the antifungal agent and fatty acid or ester showing in vitro synergistic antifungal activity), and at least one excipient, wherein said composition is devoid of C-15 or greater fatty acids and esters.
  • the fatty acid having carbon chain length ranging from C-1 to C-14 is caprylic acid.
  • the fatty acid ester having carbon chain length ranging from C-1 to C-14 is an ester of caprylic acid.
  • the caprylic acid ester is propylene glycol monocaprylate.
  • the caprylic acid ester is glyceryl monocaprylate.
  • the fatty acid having carbon chain length ranging from C- 1 to C-14 is undecvlenic acid.
  • the fatty acid having carbon chain length ranging from C-1 to C-14 is iauric acid.
  • the fatty acid ester having carbon chain length ranging from C-1 to C-14 is an ester of iauric acid.
  • the Iauric acid ester is propylene glycol monolaurate.
  • the caprylie acid ester is glyceryl monolaurate.
  • the exemplary medium chain fatty acid and their esters show synergistic behavior with all the tested antifungal agents against resistant fungi.
  • the antifungal agent in the present compositions can be selected from a group comprising allylamine class of antifungal agents, benzylamine class of antifungal agents, azole class of antifungal agents, N-hydroxy pyridone class of antifungals, echinocandin class of antifungals, polyene class of antifungals, N-hydroxy pyrithione like zinc pyrithione and combinations thereof.
  • the antifungal agent is selected from a group comprising but not limited to N-hydroxy pyridone class like piroctone olamine, ciclopirox olamine: imidazoles like ketoconazole, climbazole, miconazole nitrate, fluconazole, econazole, saperconazole, oxiconazoie, clotrimazole, bifonazole, butoconazole, fenticonazoie, isoconazole, omoconazoie, sertaconazole, suiconazoie, tioconazoie, luliconazole, chlormidazole, croconazole, eberconazole, omoconazoie, isoconazole, neticonazole; triazoles like albaconazole, efinaconazole, fosfluconazole, epoxiconazole, fluconazole, isavuconazole
  • the present disclosure further provides antimicrobiai/antifungal agents along with medium chain saturated and unsaturated fatty acids (C-1 to C-14) or ester derivatives thereof, or a synergistic combination of different antimicrobial/antifungal agents and medium chain saturated and unsaturated fatty acids (C-1 to C-14) or ester derivatives thereof to coat either in the solubilized form or nanoparticle form or in the hydrogei form on implants.
  • the compositions are used for coating latex catheters and silicone catheters.
  • the coating process involves solubilization of antimicrobial/antifungal agents and medium chain saturated and unsaturated fatty acids (C-1 to C-14) or ester derivatives thereof in suitable solubilizer/emulsifier (excipient) at particular ratios to form permanent coating on latex Foley catheters and silicone catheters.
  • C-1 to C-14 medium chain saturated and unsaturated fatty acids
  • excipient solubilizer/emulsifier
  • the emulsifiers and solubilizers used is selected from oleyl alcohol, N-methyl pyrrolidone, N-methyl pyrrolidine, PEG- 12 dimethicone, glycerol, ethanoi, diethtylene glycol monoethyiether, alkylmethylsiioxane, cyclomethicone, dimethicone or dimethicnol 40 alone or any combinations thereof provided they are compatible to the silicone based medical fluid.
  • the catheter is then immersed into the final solution containing drug and medical fluid (coatmg agent) and kept for about 3 minutes at room temperature. At the end, it is taken out of the solution and is hanged to drain solution from the catheters.
  • coated catheter is allowed to dry at about 25°C, at 55% relative humidity for about 24 hours.
  • the coating is cured in about 24 hours followed by packaging and sterilization to obtain the final coated catheters.
  • different natural synthetic polymers alone or in combination with antifungal agents or antimicrobial agents and medium chain fatty acids (C-1 to C-14) or fatty acid ester derivatives thereof in the form of hydrogei are used to coat on catheters.
  • Natural and synthetic polymers include polytetrafluoroethyelne, polymerized styrene, hydroxyethylcellulose, carboxymethylceilulose, hydroxypropylcellulose, hypromellose, ethyicelluiose alone or in combinations thereof for use as suitable hydrogei forming matrix.
  • An antifungal composition comprising at least one antifungal agent, at least one medium chain fatty acid or ester thereof, and at least one excipient, wherein a synergistic fractional inhibitory concentration (FIC) index of the combination of the antifungal agent and the medium chain fatty acid or ester thereof is less than 1.
  • FIC fractional inhibitory concentration
  • antifungal agent selected from the group consisting of terbinafine, butenafine, clotrimazole, ketoconazoie. Miconazole, bifonazole, efinaconazole, amphotericin B, caspofungin, zinc pyrithione, piroctone olamine, and any combinations thereof. 10.
  • compositions of any one of paragraphs 1 -9, wherein the composition is formulated for the purpose of topical administration, local administration and/or systemic administration in the form of oils, creams, lotions, serums, gels, hydrogeis, ointments, foams, sprays, aerosols, water based serum, coating on implants such as silicon tubes, catheters and sutures.
  • a method for managing fungal growth or treating a fungal infection comprising administering an antifungal composition as defined in the above paragraphs to a subject in need thereof.
  • a method for treating a resistant fungal infection comprising administering an antifungal composition as defined in the above paragraphs to a subject in need thereof, wherein fractional inhibitory concentration (FIC) index of a combination of the antifungal agent and the fatty acid or ester thereof in the composition is less than 1.
  • FIC fractional inhibitory concentration
  • a hair oil composition comprising piroctone olamine, propylene glycol monocaprylate and one or more excipient selected from but not limiting to the classes of surfactants, co-surfactants, emulsifiers, stabilizing agents, gelling agents, conditioning agents, moisturizing agents, preservatives, fragrance, emollients, pH modifiers, colorants, antioxidants and combinations thereof, the said composition more specifically comprising of the excipients including ethanoi, IP A, oleyl alcohol, paraffin, triacetin ethanoi, cyclomethicone, tea tree oil, tocopherol acetate, BHT, phenoxvethanol, and pH modifiers and combinations thereof.
  • excipients including ethanoi, IP A, oleyl alcohol, paraffin, triacetin ethanoi, cyclomethicone, tea tree oil, tocopherol acetate, BHT, phenoxvethanol, and pH modifiers and combinations thereof.
  • the hair oil composition defined in paragraph 33 comprising piroctone olamine at a concentration ranging from about 0.01 % to 5%, propylene glycol monocaprylate at a concentration ranging from about 0.5% to 20% and the excipient at a concentration ranging from about 45% to 99%, of the total weight of the composition.
  • a shampoo composition comprising antifungal agent selected from piroctone olamine, zinc pyrithione or a combination thereof, and propylene glycol monocaprylate along with one or more excipient selected from but not limiting to the classes of surfactants, co-surfactants, emulsifiers, stabilizing agents, gelling agents, pearlizing agents, conditioning agents, moisturizing agents, preservatives, foaming agents, fragrance, emollients, pH modifiers, colorants, antioxidants and combinations thereof.
  • antifungal agent selected from piroctone olamine, zinc pyrithione or a combination thereof
  • propylene glycol monocaprylate along with one or more excipient selected from but not limiting to the classes of surfactants, co-surfactants, emulsifiers, stabilizing agents, gelling agents, pearlizing agents, conditioning agents, moisturizing agents, preservatives, foaming agents, fragrance, emollients, pH modifiers, colorants, antioxidants and combinations thereof.
  • he shampoo composition defined in paragraph 14 comprising antifungal agent at a concentration ranging from about 0.01% to 20%, propylene glycol monocaprylate at a concentration ranging from about 0.5% to 10%> and the excipient at a concentration ranging from about 45% to 99%, of the total weight of the composition.
  • a gel or cream composition comprising antifungal agent selected from ketoconazole, clotrimazole, Miconazole or terbinafine, and propylene glycol monocaprylate along with one or more excipient selected from but not limiting to the classes of solubiiizers, surfactants, co-surfactants, emuisifiers, stabilizing agents, gelling agents, moisturizing agents, preservatives, fragrance, emollients, skin barrier repair agents, pH modifiers, penetration enhacers, cooling agents, antioxidants and combinations thereof.
  • he gel or cream composition defined in paragraph 17, comprising antifungal agent at a concentration ranging from about 0.01% to 10%, propylene glycol monocaprylate at a concentration ranging from about 0.5% to 10% and the excipient at a concentration ranging from about 45% to 99%, of the total weight of the composition.
  • lotion composition comprising antifungal agent Miconazole or piroctone olamine, and propylene glycol monocaprylate along with one or more excipient selected firom but not limiting to the classes of solubiiizers, surfactants, co-surfactants, emuisifiers, stabilizing agents, gelling agents, moisturizing agents, preservatives, fragrance, emollients, pH modifiers, penetration enhacers, skin barrier repair agents, cooling agents, antioxidants, antibacterial agents (benzothenium chloride) and combinations thereof.
  • the lotion composition defined in paragraph 19 comprising antifungal agent at a concentration ranging from about 0.01% to 20%, propylene glycol monocaprylate at a concentration ranging from about 0.5% to 20% and the excipient at a concentration ranging from about 45% to 99%, of the total weight of the composition.
  • solution based composition comprising efinaconazoie, and propylene glycol monocaprylate along with one or more excipient selected from but not limiting to the classes of solvents, solubiiizers, surfactants, co-surfactants, emuisifiers, stabilizing agents, gelling agents, moisturizing agents, preservatives, emollients, pH modifiers, penetration enhacers, antioxidants and combinations thereof.
  • solvents solubiiizers, surfactants, co-surfactants, emuisifiers, stabilizing agents, gelling agents, moisturizing agents, preservatives, emollients, pH modifiers, penetration enhacers, antioxidants and combinations thereof.
  • he solution based composition defined in paragraph 21 comprising efinaconazoie at a concentration ranging from about 0.5% to 20%, propylene glycol monocaprylate at a concentration ranging from about 0.5% to 20% and the excipient at a concentration ranging from about 45% to 99%, of the total weight of the composition.
  • water based seram composition comprising piroctone olamme, and propylene glycol monocaprylate along with one or more excipient selected from but not limiting to the classes of solvents, solubilizers, surfactants, co-surfactants, emulsifiers, stabilizing agents, gelling agents, moisturizing agents, preservatives, emollients, pH modifiers, penetration enhacers, antioxidants, and combinations thereof, the said composition more specifically comprising of the excipients including PEG- 12 dimethicone, oleth- 20, laureth 23, water, Sensomer CI 50, PEG- 120 methyl glucose trioleate, phenoxyethanol and combinations thereof.
  • the water based serum composition defined in paragraph 21, comprising piroctone olamine at a concentration ranging from about 0.01% to 20%, propylene glycol monocaprylate at a concentration ranging from about 0.5% to 20% and the excipient at a concentration ranging from about 45% to 99%, of the total weight of the composition.
  • said compositions possess antifungal activity against Malassezia spp. selected from a group comprising M. fufur, M. pachydermatis, M. giobosa, M. restricta, M. slooffiae, M. sympodialis, M. nana, M. yamatoertsis, M. dermatis, M. obtusa, M. japonica, M. caprae, M. cunicuH, M. equine,
  • compositions manage or treat indications/fungal infections selected from a group comprising dandruff, sebhoreic dermatitis, or a combination thereof.
  • compositions possess antifungal activity against Trichophyton spp. selected from a group comprising T. rubrum, T mentagrophyte, T interdigitale, T. tonsurans, T schoenleinii, T. violaceum, T. abissinicum, / ' . baicaneum, 7. circonvolutum, / ' . concentricum, T, eboreum, 7 errinacei, T, fischeri, T. fluviomuniense, T. glahrum, T. gourvilii, T. kanei, T. kuryangei, T.
  • compositions manage or treat indications/fungal infections selected from a group comprising tinea, cutaneous candidiasis, onychomycosis or any combination thereof.
  • FIC value for a drug in a particular well of the checkerboard layout is calculated by dividing the drug concentration in that well by the established MIC value of the drug against the test organism (Hsieh et al, Synergy assessed by checkerboard: A critical Analysis, Diagn. Microbiol. Infect Dis, (1993) 16:343-349).
  • FIC values for both test agents in a particular well are calculated in this way followed by determination of the FIC index (sum of the FICs of each drug in the concerned well).
  • Combinations that gave FIC indices less than i were designated "synergistic" based on the existing literature (Zhang et al Synthesis of novel sulfonamide azoles via C-N cleavage of sulfonamides by azole ring and relational antimicrobial study, New J Chem, (2015) .39:5776- 5796 and Meletiadis et al., Defining Fractional Inhibitory Concentration Index Cutoffs for Additive Interactions based on self-drag combinations, Antimicrob. Agents Chemother. (2010) 54(2): 602-609).
  • Table 1 Representative data from checkerboard assays of combination of caprylic acid with various antifungals (various classes) on Trichophyton nibrum (ATCC-28188)
  • Table 2 Representative data from checkerboard assays of combination of propylene glycol monocaprylate (caprylic acid ester) with various antifungals (various classes) on Trichophyton
  • Amphotericin B 0.5 0.125 0.25
  • Table 3 Representative data from checkerboard assays of combination of glyceryl monocapryiate with various antifungals (various classes) on Trichophyton nibrum (ATCC
  • Table 4 Representative data from checkerboard assays of combination of undecylenic acid (CI 1 ) with various known antifungals (various classes) on Trichophyton rubrum (ATCC-28188).
  • Table 8 Representative data from checkerboard assays of combination of luliconazole (azole class) with caprylic acid or glyceryl monocaprylate on C. albicans (ATCC-90028)
  • Table 10 Representative data from checkerboard assays of combination of propylene glycol monocaprylate (C8 ester) with various known antifungals on azole resistant C. albicans MTCC 22 /
  • Table 1 1 Representative data from checkerboard assays of combination of glyceryl monocaprylate (C8 ester) with various antifungals on azole resistant C. albicans MTCC 227
  • Table 12 Representative data from checkerboard assays of combination of undecylenic acid (CI 1) with various antifungals on azole resistant C. albicans MTCC 227
  • Table 14 Representative data from checkerboard assays of combination of propylene glycol nionolaurate (CI 2 ester) with various known antifungals on azole resistant C. albicans MTCC
  • 'Table 3 shows representative data from checkerboard assays of combination of glyceryl monocaprylate with various antifungals (various classes) on Trichophyton rubrum (ATCC 28188).
  • 'Table 4' shows representative data from checkerboard assays of combination of undecylenic acid (CI 1 ) with various antifungals (various classes) on Trichophyton rubrum (ATCC 28188).
  • 'Table 5' shows representative data from checkerboard assays of combination of lauric acid (CI 2) with various antifungals (various classes) on Trichophyton rubrum (ATCC 28188).
  • 'Table 6' shows representative data from checkerboard assays of combination of propylene glycol monolaurate (lauric acid ester) with various antifungals (various classes) on Trichophyton ruhrwn (ATCC 28188).
  • 'Table 7' shows representative data of synergistic action of terbinafme or butenafine with caprylic acid, propylene glycol monocaprylate and glyceryl monocaprylate against terbinafme resistant Trichophyton interdigitale (GTB-2S).
  • 'Table 8' shows representative synergistic combinations of Miconazole with caprylic acid or its ester (glyceryl monocaprylate) on C, albicans (ATCC 90028).
  • Glyceryl monocaprylate also shows synergistic action with various antifungals on azole resistant C, albicans MTCC 227 as shown in 'Table l l ⁇
  • Representative data from checkerboard assays of combination of undecylenic acid (Cl l) with various antifungals on azole resistant C, albicans MTCC 227 clearly demonstrates synergistic antifungal properties ('Table 12').
  • 'Table 13 ' shows representative synergistic data from checkerboard assays of combination of lauric acid (CI 2) with various known antifungals on azole resistant C. albicans MTCC 227.
  • an ester of lauric acid, propylene glycol monolaurate also demonstrates synergistic action on azole resistant C. albicans MTCC 227 when in combination with various known antifungals ('Table 14').
  • compositions were prepared by dissolving the active agent in ethanoi or isopropyl alcohol (IPA). The oleyl alcohol was then added and stirred until a homogenous solution was obtained. Other excipients or additives were added and stirred to get clear solution except liquid paraffin. Weight was finally made up with liquid paraffin and stirred, until homogenous solution was obtained. Final formulations were clear transparent oil solutions. 'Table 15' describes anti-fungal clear oil compositions containing piroctone olamine as anti-fungal agent and medium chain fatty acid and/or esters using various excipients or additives.
  • compositions using liquid paraffin as base oil (excipient) containing piroctone olamine were clear oil solutions.
  • compositions were prepared by dissolving the active agent in ethanol. The oleyl alcohol was then added and stirred until homogenous solution was obtained. Other excipients or additives were added and stirred to get clear solution except liquid paraffin. Weight was finally made up with liquid paraffin and stirred until homogenous solution was obtained. Final formulations were clear transparent oil solutions. 'Table 16' describes anti-fungal clear oil compositions containing ketoconazole as anti-fungal agent and medium chain fatty acid and/or esters using various excipients or additives.
  • Example 4 Study of Fatty Acid/Esters having C-15 or Greater carbon chain length as a source of nutrients for the growth of Malassezia spp.
  • Malassezia species are lipophilic unipolar yeasts recognized as commensals of skin that may be pathogenic under certain conditions (Jindo et al 2004; Indian Journal of Medical Microbiology (22: 179), To compare lipid requirements of the fungus most closely associated with dandruff/seborrheic dermatitis, the best studied Malassezia species is M. furfur. Lipid assimilation in vitro assay was designed to investigate lipid effect on growth of M. furfur (MTCC 1374). Method: Briefly, Sabouraud Dextrose containing low-melt agar was melted, cooled to 38°C.
  • Fatty acids/esters constituents eg, propylene glycol monocaprylate (C-8), capric acid (C-10), caprylic acid (C-8), linoleic acid (C- 18), oleic acid (C-1 8), palmitic acid (C-16), ethyl oleate (C- 18), and oils containing fatty acid/esters eg, coconut oil, mustard oil etc., were added to study the growth of the fungus (Kaw Bing CHUA, et al Malaysian J Pathol (2005) 27(2): 99). After solidification, agar plates were streaked with M. furfur innoculum adjusted to appropriate cfu/ml, aseptically. Positive control with 2% olive oil and negative control without fatty substance were also maintained. The results are provided in Figure 2.
  • Culture media which contained C- 15 or greater fatty acids or esters eg, linoleic acid, oleic acid, palmitic acid, ethyl oleate and oils containing fatty acid/esters eg, coconut oil, mustard oil etc. showed confluent growth of fungus after 6 days.
  • the Minimum Inhibitory Concentration (MIC) is considered as an index for indicating antifungal efficacy. Therefore, lower the value of MIC of the composition, the better is its antifungal efficacy.
  • the in vitro activities of some of the oil compositions containing ketoconazoie against Malassezia furfur were determined by agar dilution methods. Appropriate dilutions of antifungal compositions were added to molten Leeming Notman Medium. Once the plates were set, M. furfur innoculum adjusted to appropriate cfu/ml was streaked on the agar plates and incubated for 6 days. After incubation, the plates were observed at day 3 and day 6 for visible M. furfur growth. The MIC is defined as the lowest tested dilution of antifungal active that yields no growth.
  • Ketoconazole containing oil compositions showed MIC at 0.25 ⁇ ig/ml, which is similar to the MIC of positive control where drug is dissolved in DMSO at the same concentration as shown in 'Table 18'.
  • compositions were prepared by dissolving the active agent in ethanol or other suitable solvent. The oleyl alcohol was then added and stirred until a homogenous solution was obtained. Other excipients or additives were added and stirred to obtain a clear solution except liquid paraffin. The total volume was finally made up with liquid paraffin and stirred until homogenous solution was obtained.
  • Final formulations were clear transparent oil solutions and coded as I P, 2P, 3 P and 4P as given in 'Table 19'. Ail compositions are clear transparent solutions. In compositions I P and 2P, caprylic acid was added to balance the pH of the formulations.
  • oil compositions containing piroctone olamine devoid of C-15 or greater fatty acids or their esters showed MIC in the range of 16-32 ⁇ against M. furfur (MTCC 1374) and in the range of 8-16 against M obtusa (CBS 7876).
  • Composition having similar amount of piroctone olamine with 5% sunflower oil and 10% oleic acid were showed MIC at 64 against both the strains.
  • Table 20 MIC of oil compositions containing piroctone olamine and caprylic acid and/or its ester against M. furfur (MTCC 1374)
  • Table 21 MIC for oil compositions containing piroctone olamine and caprylic acid and/or its ester against M. obtusa (CBS 7876)
  • compositions were prepared by dissolving the active agent in ethanol or other suitable solvent. The oleyl alcohol was then added and stirred until a homogenous solution was obtained. Other excipients or additives were added and stirred to obtain a clear solution except liquid paraffin. The total volume was finally made up with liquid paraffin and stirred until homogenous solution was obtained. Final formulations were clear transparent oil solutions and coded as IK, 2K, as given in 'Table 22'. All compositions are clear transparent solutions.
  • compositions were prepared by dissolving the active agent in ethanol or other suitable solvent. The oleyl alcohol was then added and stirred until a homogenous solution was obtained. Other excipients or additives were added and stirred to obtain a clear solution except liquid paraffin. The total volume was finally made up with liquid paraffin and stirred until homogenous solution was obtained. Final formulations were clear transparent oil solutions and coded as 1 PK, 2PK, as given in 'Table 23 ' . d
  • compositions were prepared as described above (Example 6, D) and coded as 3 PM, 2PM and 3PM, as given in 'Table 24'. Table 24; Oil compositions containing piroctone olamine as antifungal agent, minoxidil and caprylic acid and/or its ester
  • carbopol was added to the water and allowed to swell for 24 hours.
  • Antidandruff agent was dissolved in minimum quantity of solvent and added to the carbopol base, followed by neutralization with a dilute aqueous solution of triethanoiamine or sodium hydroxide to obtain pH 5.0-7.0.
  • the gel compositions were coded as IG, 2G, 3G, 4G, 5G and 6G as shown in 'Table
  • Table 25 Gel compositions containing antifungal agents devoid of C-15 or greater fatty acids/esters
  • Zone of Inhibition of Gel Compositions Devoid of C-15 or Greater Fatty Acids/Esters Containing Antifungal Agent Piroctone Diamine against M. furfur under in vitro Conditions.
  • Creams were prepared by fusion method, where ail oil soluble ingredients were weighed and melt at a temperature of 60-80° C. Aqueous phase was maintained at the same temperature and oil phase was poured into aqueous phase with constant stirring, followed by slow cooling with moderate stirring. The cream compositions were coded as 1C, 2C, 3C, 4C as shown in 'Table 27'.
  • Example 10 Preparation of clotrimazole (1 %) topical cream formulations containing at least one or two medium chain fatty acids (between C-1 to C-14) or ester derivatives thereof (Table 28)
  • Phase A Purified water, carbopol 980, sodium hyaiuronate
  • Phase B Clotrimazole, cetostearyl alcohol, propylene glycol monocaprylate, glyceryl monocaprylate, glyceryl mono-di caprylate, propylene glycol monolaurate, glycerol monolaurate, diisopropyladipate, propylene glycol, mineral oil, cetomacrogol 1000, PEG- 12- dimethicone, steareth 2, steareth 21,
  • Phase C Benzyl alcohol, butyiated hydroxy toluene
  • phase A like carbopol 980 is added slowly into water while maintaining the stirring speed at about 600-700 RPM till the polymers are homogenously suspended into water to form homogenous phase A (aqueous phase).
  • phase B All the ingredients of phase B (mineral oil, cresmer 1000, PEG 400, cetostearyl alcohol, propylene glycol monocaprylate, steareth 2, steareth 21 etc.) are mixed and melted at 70 ° C.
  • Clotrimazole is added into phase B (oil phase) which is further added into phase A at 70°C by maintaining stirring speed at about 200-300 RPM until homogeneous phase is obtained. The stirring is continued till the temperature of the final mixture reaches at 30- 35 °C.
  • Phase C ingredients (butyiated hydroxytoluene and benzyl alcohol) are added to the above homogeneous mixture while maintaining the stirring at about 200-300 RPM. Finally, the reaction mixture is neutralized with triethanolamine to attain final pH at about 6.5 to 7.0.
  • the exemplary cream formulations F2-F8 with the respective compositions as mentioned in Table 28 are prepared using similar method as used for Fl. Table 28: Clotrimazole (1%) topical cream formulations with at least one or two medium
  • Example 11 Preparation of Miconazole (1%) topical cream formulations containing at least one or two medium chain fatty acids or derivatives thereof (Table 29)
  • phase A like carbopol 980 is added slowly into water while maintaining the stirring speed at about 600-700 RPM till the polymers are homogenously suspended into water to form homogenous phase A (aqueous phase).
  • phase B all the ingredient of phase B (cetostearyl alcohol, di-isopropyi adipate, propylene glycol monocaprylate, steareth 2, steareth 21 etc) are mixed and melted at 70°C.
  • Phase B oil phase
  • phase A oil phase
  • stirring speed at about 200-300 RPM until homogeneous phase is obtained.
  • the stirring is continued till the temperature of the final mixture reaches at 30-35 °C.
  • Phase C ingredients (butylated hydroxytoluene and benzyl alcohol) are added to above homogeneous mixture while maintaining the stirring at about 200-300 RPM. Finally, the reaction mixture is neutralized with triethanoiamine to attain final pH at about 6.5 to 7.0.
  • Table 29 Luliconazoie ( 1%) topical cream formulation with at least one or two medium chain
  • Phase A Water, propylene glycol, tween 20
  • Phase B Terbinafme HCl, cetyl alcohol, stearyl alcohol, eetostearyl alcohol, propylene glycol monocapryiate, dimethyl isosorbide, steareth 2, steareth 21, dimethicone
  • Phase C Carbopol 980, hydroxypropylcellulose
  • Phase D Benzyl alcohol, BHT, glycerine
  • phase A containing water and propylene glycol
  • phase B All the ingredient of phase B (cetyl alcohol, stearyl alcohol, propylene glycol monocapryiate, dimethyl isosorbide, steareth 2, steareth 21) are mixed and melted at 70 D C.
  • Phase C ingredients (benzyl alcohol) are added to above homogeneous mixture while maintaining the stirring at about 200-300 RPM. Finally, the reaction mixture is neutralized with triethanolamine to attain final pH at about 6.5 to 7.0.
  • the exemplary cream formulations F16-F20 with the respective compositions as mentioned in Table 30 are prepared using similar method as used for F15.
  • Table 30 Terbinafme ( 1%) topical cream formulation with at least one or two medium chain fatty acids and derivatives thereof
  • Phase A Water, propylene glycol, PEG 300, PEG 400, ethanol, isopropyl alcohol.
  • PhaseB Luhconazole, propylene glycol moiiocaprylate, di ethylene glycol, diisopropyladipate, ceteareth 20, PEG- 12-dimethicone, oleth 20
  • Phase C Benzyl alcohol, butylated hydroxy toluene
  • BHT is soiubilized in benzyl alcohol, and add into the final mixture vessel at 30-35°C.
  • the exemplar ⁇ ' lotion formulations LN02- LN08 with the respective compositions as mentioned in Table 31 are prepared using similar method as used for LNO 1.
  • Table 31 Luliconazole (1%) topical lotion formulation without ethanol containing at least one or
  • Example 14 Preparation of luliconazoie (1 %) topical lotion formulation with cthanol containing at least one or two medium chain fatty acid and fatty acid derivatives (Table 32) Phase A: Water, propylene glycol, PEG 300, PEG 400, ethanol, isopropyl alcohol, 1 ,3 propanediol
  • Phase B Luliconazole, propylene glycol monocaprylate, diethylene glycol, diisopropyladipate, ceteareth 20, PEG-12-dimethicone, oleth 20
  • Phase C Benzyl alcohol, butylated hydroxy toluene.
  • Phase B contents is added into phase A slowly with stirring. The stirring is continued till the temperature of the final mixture reaches at 30-35°C.
  • BHT is solubilized in benzyl alcohol, and add into the final mixture vessel at 30 ⁇ 35°C.
  • the exemplary lotion formulations LNI0-LN15 with the respective compositions as mentioned in Table 32 are prepared using similar method as used for LN09.
  • Table 32 Luliconazole (1 %) topical lotion formulation with ethanol containing at least one or
  • Example 15 Preparation of efinaconazole (1 %) topical nail solution with at least one or two medium chairs fattv acid and fattv acid derivatives (Table 33)
  • Phase B is slowly added into phase A to form homogenous transparent solution while stirring the final mixture at 50-100 rpm.
  • composition with structured surfactants containing at least one or two medium chain fatty acid and fatty acid derivatives (Table 34)
  • Phase A Water, Guar hydroxypropyltrimonium chloride, citric acid solution
  • Phase B Trisodium ethyl enediamine disuccinate
  • Phase D Iselux SLC, Miracare SLB 365, sodium lauryl ether sulphate, sodium iauryi suphate, cocaamidopropylbetaine, sodium cocoyl methyl taurate solution
  • Phase E Ketoconazoie, glyceryl mono/di-caprate and eapryiate, propylene glycol monocaprylate, laureth 4, laureth 23
  • Phase F Zinc pyrithione solid or dispersion
  • Trisodium ethyienediamine disuccinate and sodium chloride solution are added into the above mixture while stirring at 200 rpm.
  • ketoconazoie is dissolved in mixture of propylene glycol mono caprylate and glyceryl mono/di-caprate/caprylate while heating the mixture at 50-60 °C till ketoconazoie dissolves.
  • Ketoconazoie solubilized solution was added into the main mixing vessel at 50 °C and stirred at 50-100 rpm for 5 minutes until homogeneous phase is obtained. The stirring is continued till the temperature of the final mixture reaches at 30-35°C
  • Phase G is added into the main mixing vessel.
  • Citric acid solution is added to the final mixture to adjust the pH 6-7,
  • Colorant (if any) is going to be added at last to obtain final shampoo formulation.
  • the exemplary shampoo formulations SH02-SH08 with the respective compositions as mentioned in Table 34 are prepared using similar method as used for S1T01.
  • Phase A Purified water, carbopol aqua SF-2, guar hydroxypropyltrimonium chloride
  • Phase B W'ater, sodium lauroyl sarcosinate, sodium lauroarnphoacetate, cocamide MEA water, cocaamidopropyl betaine
  • Phase C Ketoconazole, glyceryl caprate/caprylate, propylene glycol monocaprylate
  • Phase F Phenoxyethanol, butylated hydroxy toluene.
  • carbopol aqua SF-2 is dispersed in water.
  • phase B sodium lauroyl sarcosinate, sodiumlauroamphoacetate, cocamide MEA, cocaamidopropyl betaine
  • Phase B is added into the main mixing vessel maintaining the temperature at 50 -60 °C while stirring the mixture at 100 rpm.
  • ketoconazole is dissolved in mixture of propylene glycol mono caprylate and glyceryl mono/di-caprate/caprylate while heating the mixture at 50-60 °C till ketoconazole dissolves.
  • Ketoconazole solubilized solution was added into the main mixing vessel at 50 °C and stirred at 50-100 rpm for 5 minutes until homogeneous phase is obtained. The stirring is continued till the temperature of the final mixture reaches at 30-35°C
  • Phase F and G are added sequentially while stirring the final solution for half an hour till the homogenous solution is obtained.
  • Citric acid solution is added to adjust the pH 6-7.
  • Colorant is going to be added at last to obtain final shampoo formulation.
  • the exemplary shampoo formulations SH10-SH1 1 with the respective compositions as mentioned in Table 35 are prepared using similar method as used for SH09.
  • Example 18 In vitro fangal kill efficacy of a terbinafine formulation containing C-l to C-14 fatty acid or it's ester (propylene glycol monocaprylate) against terbinafine resistant Trichophyton interdigitale (GTB-2S) in a time kill assay
  • Clotrimazole formulations test formulations
  • propylene glycol monocaprylate outperformed marketed clotrimazole formulations (clotrimazole creams from Gienmark Pharmaceuticals Ltd and Bayer Pharmaceuticals Pvt. Ltd.) and showed distinctively larger zone of inhibition against the azole resistant T. ruhrum ( Figure 4).
  • Example 20 In vitro potency of a clotrimazole formulation containing C-l to C-1.4 fatty acid or it's ester (propylene glycol monocapryiate) against an azole resistant C. albicans strain (MTCC 227) in zone of inhibition assays (ZOI)
  • Clotrimazole formulations test formulations
  • propylene glycol monocapryiate outperformed marketed clotrimazole formulations (clotrimazole creams from Glenmark Pharmaceuticals Ltd and Bayer Pharmaceuticals Pvt. Ltd.) and showed distinctively larger zone of inhibition against the azole resistant C. albicans ( Figure 5).
  • Example 21 In vitro fungal kill efficacy of a luliconazole formulation containing C-l to C- 14 fatty acid or it's ester (propylene glycol monocapryiate) against azole resistant C albicans (MTCC 227) in a time kill assay
  • Luliconazoie formulations containing propylene glycol monocapryiate (test formulation) outperformed marketed luliconazoie formulations (luliconazoie 1% creams from Glenmark pharmaceuticals Ltd and Sun Pharmaceutical Ind. Ltd.) and showed distinctively larger zone of inhibition against the azole resistant C, albicans ( Figure 7).
  • Phase B ingredients were weighed and heated to 65 - 70°C
  • Phase A was added to phase B slowly with continuous stirring at 700 rpm
  • phase C ingredients to the mixture of phase A and phase B with continuous stirring at 700 rpm
  • Table 36 Exemplary hair serum formulations containing an antifungal agent with at least one or two medium chain fatty acids and derivatives thereof
  • Example 27 Preparation of antimicrobial body lotion formulations containing an antifungal agent with at least one or two medium chain fatty acids and derivatives thereof (Table 37)
  • Phase A ingredients were weighed together and heated to 65 - 70°C.
  • Phase B ingredients were weighed together and heated to 65 - 70°C.
  • Phase A ingredients were added to phase B ingredients slowly with continuous stirring at 700 rpm.
  • Example 28 Preparation of formulations for coating surgical implants containing an antifungal antimicrobial agent with at least one or two medium chain fatty acids and derivatives thereof (Table 38)
  • Clotrimazole is solubilized in propylene glycol monocaprylate.
  • Catheter is hanged with a clip or holder at 25°C temperature and 55% RH for 24 h.
  • the coated catheter is than sterilized and packed for further use.
  • the exemplar ⁇ ' implant coating formulations CCF2-CCF6 with the respective compositions as mentioned in Table 38 are prepared using similar method as used for CCFi .
  • Table 38 Exemplary formulations for coating surgical implants containing an antimicrobial agent with at least one or two medium chain fatty acids and derivatives thereof.
  • compositions/formulations devoid of higher chain fatty acids/esters (greater than C I 4 or more) and containing medium chain fatty acids (C- l to C- 14) and/or esters thereof with antifungal agents (optionally along with excipients) show improved antifungal activity.
  • said combinations/compositions were shown to possess improved/synergistic activity also against drag resistant fungi.

Abstract

La présente invention concerne le domaine des antimicrobiens et des sciences pharmaceutiques. L'invention concerne des compositions antifongiques destinées à la gestion de la croissance fongique et au traitement d'infections fongiques, y compris le traitement d'infections fongiques résistantes. Les présentes compositions comprennent au moins un agent antifongique et au moins un acide gras saturé ou insaturé à chaîne moyenne ayant une longueur de chaîne carbonée de C-1 à C-14 ou un ester de celui-ci, éventuellement avec un ou des excipient(s), ce qui donne lieu à une activité antifongique synergique.
PCT/IB2017/053505 2016-06-13 2017-06-13 Compositions antifongiques synergiques et leurs procédés WO2017216722A2 (fr)

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JP2018566346A JP2019521993A (ja) 2016-06-13 2017-06-13 相乗的な抗真菌組成物及びその方法
EP17742542.8A EP3468544A2 (fr) 2016-06-13 2017-06-13 Compositions antifongiques synergiques et leurs procédés
AU2017283785A AU2017283785A1 (en) 2016-06-13 2017-06-13 Synergistic antifungal compositions and methods thereof
CN201780049586.2A CN109689034A (zh) 2016-06-13 2017-06-13 协同抗真菌组合物及其方法
MX2018015475A MX2018015475A (es) 2016-06-13 2017-06-13 Composiciones antifungicas sinérgicas y métodos de las mismas.
EA201990025A EA201990025A1 (ru) 2017-02-17 2017-06-13 Синергические противогрибковые композиции и способы их приготовления
KR1020197001063A KR20190037229A (ko) 2016-06-13 2017-06-13 상승효과적 항진균 조성물 및 그의 방법
BR112018075998-8A BR112018075998A2 (pt) 2016-06-13 2017-06-13 composições antifúngicas sinérgicas e métodos das mesmas
US16/309,751 US20190142800A1 (en) 2016-06-13 2017-06-13 Synergistic antifungal compositions and methods thereof
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