Final answer:
Nystatin is a broad-spectrum topical antifungal used for treating infections with Candida albicans, including oral, skin, and vaginal candidiasis. Clotrimazole and miconazole are also common topical antifungals. For systemic candidiasis, fluconazole and amphotericin B are potential options.
Step-by-step explanation:
The antifungal drug that is a broad-spectrum agent used topically for the treatment of oral, skin, and vaginal infections with Candida albicans is nystatin. Nystatin works by binding to sterols in the fungal cell membranes, creating pores that lead to cell death. It is a polyene antifungal with significant utility in treating cutaneous, mucosal, and intestinal candidiasis. In addition to nystatin, azoles such as clotrimazole and miconazole are also commonly used in topical treatments for Candida infections, offering a broad range of activity against these fungal pathogens. Clotrimazole is especially noteworthy for its safety profile in pregnancy and is an FDA category B drug. These medications, which include other agents like butoconazole, tioconazole, and terbinafine, can be part of a treatment regimen tailored to the specific location and severity of the infection.
For systemic fungal infections, options such as amphotericin B and the triazole drug fluconazole may be used, with fluconazole being available both orally and intravenously. Azoles target ergosterol biosynthesis, which leads to increased fungal cell membrane permeability and eventually cell death. Terbinafine, another antifungal, works by inhibiting an early step in ergosterol biosynthesis and is used against dermatophytic infections. However, systemic use of terbinafine for nail fungal infections must be closely monitored due to the rare side effect of hepatotoxicity.