Effect of the 1064 Nm Nd: Yag Laser on the Mics of Antifungals Used in Clinical Practice for the Treatment of Fungal Nail Infections Publisher



Razavyoon T¹ ; Hashemi SJ¹ ; Mansouri P² ; Ghazvini RD¹ ; Khodavaisy S¹ ; Bakhshi H¹ ; Ansari S³ ; Rafat Z⁴ ; Nikkhah N² ; Mohajer B¹ ; Razavyoon S¹ ; Roostaei D⁵ Show Affiliations
Source: Journal of Lasers in Medical Sciences Published:2023

Abstract

Introduction: The fungal nail infection (onychomycosis) involves 18%-40% of all nail disorders, which, although not fatal, can cause mechanical, aesthetic, occupational, and economic problems. Drug treatments due to prolonged treatment periods, drug interactions, adverse effects, and slow progression may associate with numerous negative outcomes. This study aimed to evaluate the long-pulsed 1064-nm Nd: YAG laser effect on fungal colonies and subsequently possible change in the minimum inhibitory concentrations (MICs) of common antifungals compared with the same non-lasered colonies as a novel way to investigate laser and antifungal interaction. Methods: Sixty onychomycosis samples consisting of saprophyte (n = 20), dermatophyte (n = 20), and yeast (n = 20) duplicate colonies were isolated. A series was treated by a long-pulsed 1064-nm Nd: YAG laser. Afterward, the MIC (CLSI-M38-A2 and CLSI-M27-A3) of two series against common antifungals were compared. Results: After 1064-nm Nd: YAG laser irradiation in all 20 tested saprophytes, the MICs of terbinafine (P value < 0.035) were changed, and in all 20 tested dermatophytes, the MICs of voriconazole (P value < 0.021) were changed. Also, in all 20 tested yeasts, the MICs of caspofungin (P value < 0.037) were changed. Moreover, in saprophytes, dermatophytes, and yeasts, significant changes in the MICs of itraconazole (P value < 0.032), terbinafine (P value < 0.025), and caspofungin (P value < 0.037) were detected. Our result showed the GM MICs of the 1064-nm Nd: YAG laser in all saprophyte, dermatophyte, and yeast groups were lower than in the control group. Conclusion: The present study indicated that the long-pulsed 1064-nm Nd: YAG laser significantly changes the MICs of antifungals in onychomycosis clinical samples. © (2023), (Laser Application in Medical Sciences Research Center). All Rights Reserved.