Treatment of tinea pedis when bacterial presence is suspected: A review of the literature

Academic Article


  • The most common fungal infection, tinea pedis, is estimated to affect up to 70% of the general population in the United States. There are four subtypes of tinea pedis: interdigital, moccasin, inflammatory, and ulcerative. Although tinea pedis is primarily caused by various species of Trichophyton and Epidermophyton, other moulds such as Scytalidium, and the yeast Candida, have also been implicated. In addition, however, some infections found in macerated toe-web interspaces will also contain bacteria. When a patient develops clinical signs and symptoms suggestive of bacterial infection, such as foot odor, pruritus, maceration, and inflammation, a mixed fungal/bacterial infection should be suspected. In such situations, bacteria may play an important role in the pathogenesis of the infection and in erosions of the toe-web space. The bacteria implicated in these cases include the most common, Staphylococcus aureus, as well as Micrococcus sendentarius, Pseudomonas aeruginosa, and Corynebacterium minutissimum. This condition has been termed 'dermatophytosis complex', in view of the fact that dermatophytes often fail to grow due to the bacteria inhibition factors. Econazole nitrate, a member of the azole class, is a broad-spectrum antifungal drug effective in the treatment of tinea pedis, tinea cruris, tinea corporis, tinea versicolor, and cutaneous candidiasis. In addition, this versatile agent is also effective against bacteria, especially several gram-positive species, which is particularly useful for treating cases of mixed fungal and bacterial infection.
  • Authors

    Published In

    Author List

  • Elewski BE; Berlin SJ; Nyirady J
  • Start Page

  • 159
  • End Page

  • 165
  • Volume

  • 17
  • Issue

  • 2