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chlorhexidine dihydrochloride + dexamethasone + nystatin (Nystalocal)

✓ Approved

Medinova · Small Molecule · Small Molecule

What is chlorhexidine dihydrochloride + dexamethasone + nystatin?

chlorhexidine dihydrochloride + dexamethasone + nystatin is a small molecule developed by Medinova. It is approved for therapeutic indications via topical.

Drug Profile

Brand NamesNystalocal
CompanyMedinova
Drug ClassSmall Molecule
RouteTopical
StatusApproved
Sources: ClinicalTrials.gov, Medinova

Therapeutic Indications

chlorhexidine dihydrochloride + dexamethasone + nystatin is developed for 2 unique indications across 2 therapeutic areas.

Therapeutic AreaConditionPhase
InvestigationsDermatologic examination✓ Approved
Infections and infestationsCandida infection✓ Approved

Related Research Articles

PubMedFrontiers in endocrinology2026-09-19

Plasma cortisol cut-off concentrations using the dexamethasone suppression test in patients with adrenal incidentalomas.

Jørgensen Nanna Thurmann NT, Borresen Stina Willemoes SW, Hilsted Linda L, Christoffersen Christina C et al.

Assessment of cortisol secretion in patients with adrenal incidentalomas remains challenging. We evaluated the guideline-recommended cortisol cut-off value for cortisol suppression (50 nmol/L) following a 1 mg overnight dexamethasone suppression test (DST) against a control-derived threshold and compared patient classification using the two thresholds. Secondary objectives included assessing associations of pre-DST ACTH, post-DST dexamethasone, and comorbidities with post-DST cortisol. In this cross-sectional study (NCT07350031), pre- and post-DST plasma samples from patients with adrenal incidentalomas (N = 108) and matched controls (N = 101) were prospectively collected, and cortisol was analysed using immunoassay (Elecsys®Cort II) and LC-MS/MS. Post-DST dexamethasone ≥3 nmol/L defined appropriate dexamethasone exposure. The 97.5th percentile of LC-MS/MS-measured post-DST cortisol in controls defined the control-derived threshold. Associations between pre-DST ACTH, post-DST dexamethasone, and post-DST cortisol were assessed. The performance of pre-DST ACTH for identifying post-DST cortisol >50 nmol/L was evaluated using receiver operating characteristic analysis. Logistic regression examined associations between post-DST cortisol and diabetes, dyslipidaemia, hypertension, and osteoporosis. The 97.5th percentile of post-DST cortisol in controls was 66 nmol/L. The 50 nmol/L threshold corresponded to the 90th percentile of controls and classified 44% of patients as having hypercortisolism, compared with 26% using the control-derived threshold (66 nmol/L). Pre-DST ACTH showed poor discrimination for post-DST cortisol >50 nmol/L (AUC 0.69). Post-DST cortisol was not associated with dexamethasone concentrations or comorbidities. The guideline-recommended post-DST cortisol threshold of 50 nmol/L may be too low, suggesting that higher thresholds warrant further evaluation.

PMID 42760967
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PubMedFrontiers in endocrinology2026-09-19

A control theoretic primer for systems endocrinology.

Boroujerdi Massoud M

Endocrine systems are characterised by complex dynamic behaviours-oscillations, transient responses, feedback regulation, and noise filtering-that are essential to physiological stability. Despite extensive molecular and clinical research, the quantitative principles governing these dynamics remain incompletely understood. In particular, the mechanistic relationship between the metabolic clearance rates of individual hormones and emergent system-level properties such as oscillatory frequency, damping, and stability has not been systematically integrated into endocrine theory. This paper introduces a control-theoretic framework for systems endocrinology, modelling endocrine networks as cascades of second-order negative feedback systems whose parameters are derived directly from measurable clearance-rate values. Two transfer function architectures are defined-G-type (feed-forward) and H-type (feedback)-which encode a spectrum from rapid, responsive regulation to stable, noise-rejecting maintenance. Frequency-domain analysis via Bode plots extracts biologically interpretable metrics including cutoff frequency, bandwidth, phase margin, and stability margins. The framework is demonstrated using the cortisol-HPA axis as a worked example, where model-predicted timescales are shown to be consistent with experimentally observed ultradian pulsatility (~90-minute period), ACTH-stimulation response kinetics, and dexamethasone suppression dynamics. A reference table of clearance-rate-derived parameters for 36 hormones and substrates is provided, enabling immediate application across major endocrine axes. All computational tools are implemented in R and made freely available. By translating standard pharmacokinetic data into the language of control engineering, the framework provides a candidate, testable account of questions that static endocrine models leave qualitative: why cortisol pulsatility occurs on an approximately ultradian timescale, how stable the HPA axis is, and why the timing-not just the dose-of cortisol replacement determines clinical outcome.

PMID 42761052
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PubMedHeart & lung : the journal of critical care2026-09-18

Comparison of analgesic efficacy of dexamethasone and dexmedetomidine as an adjuvant to local anaesthetic in transversus thoracic muscle plane block in adult patients undergoing median sternotomy: A randomised controlled trial.

Kumari Poonam P, Jha Lalit L, Kumar Amarjeet A, Sinha Chandni C et al.

Post-sternotomy pain contributes significantly to delayed recovery following cardiac surgery. The transversus thoracic muscle plane block (TTPB) is a recently described regional anaesthetic technique that provides analgesia to the anterior chest wall. The addition of adjuvants such as dexamethasone and dexmedetomidine may enhance the analgesic efficacy of TTPB. This study compared the analgesic efficacy of dexamethasone and dexmedetomidine as adjuvants to bupivacaine for TTPB in patients undergoing median sternotomy. 66 adult patients (ASA I-III) scheduled for cardiac surgery via median sternotomy were recruited for this randomised trial. Following induction of anaesthesia, all patients received bilateral TTPB and were allocated to three groups: dexamethasone (0.25 % bupivacaine + 8 mg dexamethasone), dexmedetomidine (0.25 % bupivacaine + 1 µg/kg dexmedetomidine), and a control group (0.25 % bupivacaine alone). The primary outcome was the time to first rescue analgesia following extubation. Secondary outcomes included 24-hour postoperative fentanyl consumption, intraoperative fentanyl requirement, pain scores, extubation time, patient satisfaction, and adverse events. Time to first rescue analgesia was significantly longer in the dexmedetomidine group than in the dexamethasone and control groups (P 0.001). Twenty-four-hour postoperative fentanyl consumption was significantly lower in both adjuvant groups than in the control group (P < 0.001). Pain scores were consistently lower with dexmedetomidine and dexamethasone groups. Extubation time and intraoperative fentanyl consumption were comparable among the three groups (P > 0.05). Both dexamethasone and dexmedetomidine improved TTPB analgesia. Dexmedetomidine significantly prolonged the duration of analgesia, whereas 24-hour postoperative opioid consumption was comparable between the adjuvant groups.

PMID 42759104
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PubMedPhotodiagnosis and photodynamic therapy2026-09-18

In vitro evaluation of photodynamic therapy associated with irrigation protocols in the control of multispecies endodontic biofilm.

Cardozo Bianca B, Pereira Ana Carolina Cambuí ACC, Mita Daniela D, Nunes Erica Miyazima EM et al.

To evaluate the antimicrobial efficacy of antimicrobial photodynamic therapy (aPDT), either alone or in combination with various irrigation protocols, against mature multispecies biofilms. Multispecies biofilms consisting of nine bacterial species were cultivated on 72 bovine dentin discs and randomly assigned to six groups (n = 12 each): saline (control), saline + aPDT, 2.5% sodium hypochlorite (NaOCl) + 17% EDTA, NaOCl + EDTA + aPDT, 2% chlorhexidine (CHX) + EDTA, and CHX + EDTA + aPDT. aPDT was performed using 0.005% methylene blue and a red diode laser (660 nm, 100 mW, 9 J, 90 s). The antimicrobial efficacy was assessed through colony-forming unit (CFU) counts and confocal laser scanning microscopy (CLSM). The data were analyzed using a significance level of 5%. The saline control exhibited the highest microbial load, which was significantly reduced when combined with aPDT (p < 0.05). Both NaOCl and CHX, in the absence of aPDT, significantly decreased microbial levels compared to saline (p < 0.05). When used alongside aPDT, NaOCl resulted in the lowest CFU values; however, no additional antimicrobial benefit from light activation was observed. The antimicrobial reduction achieved with saline + aPDT was comparable to 2% CHX. CLSM analysis corroborated these findings. aPDT enhanced the antimicrobial efficacy of physiological saline, resulting in an antimicrobial effect comparable to that observed with 2% liquid chlorhexidine. Among the irrigation protocols evaluated, 2.5% sodium hypochlorite showed the greatest antimicrobial efficacy, with no significant additional benefit following the application of aPDT.

PMID 42759825
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PubMedMedeniyet medical journal2026-09-18

In Vitro Antifungal Activity of Commonly Used Antiseptics and Disinfectants Against Candida auris Isolates.

Habip Zafer Z, Koçoğlu Mücahide Esra ME, Güneysu Yarar Büşra B, Özmen Merve M et al.

Candida auris (C. auris) has emerged as a multidrug-resistant nosocomial pathogen associated with outbreaks in healthcare settings and high mortality rates. Its ability to persist in the hospital environment highlights the importance of effective disinfection strategies. This study aimed to evaluate the in vitro susceptibility of clinical C. auris isolates to commonly used antiseptics and disinfectants under conditions reflecting routine clinical practice. Ten clinical C. auris isolates, along with reference strains of C. krusei (ATCC 6258) and C. parapsilosis (ATCC 22019), were tested. Sodium hypochlorite (5%, 1%, 0.5%), hydrogen peroxide (6%, 3%), povidone-iodine (10%, 5%, 2.5%), a chlorhexidine/n-propanol-containing liquid soap, and an ethanol/isopropyl alcohol-based hand disinfectant were evaluated by a qualitative suspension test at contact times of 1, 2, 5, 10, and 30 minutes. Growth inhibition was assessed after incubation. Povidone-iodine at all concentrations, chlorhexidine/n-propanol-containing liquid soap, alcohol-based hand disinfectant, and sodium hypochlorite at 5% and 1% achieved complete growth inhibition of all isolates within the first minute. In contrast, 0.5% sodium hypochlorite and hydrogen peroxide showed reduced efficacy at early contact times. Growth was observed in some C. auris isolates after 1 minute of exposure to 6% hydrogen peroxide, and in a larger proportion of isolates after 1-2 minutes of exposure to 3% hydrogen peroxide. Similar variability was observed in reference strains, particularly with hydrogen peroxide. Commonly used antiseptics and disinfectants are effective against C. auris when applied at appropriate concentrations and contact times. However, reduced efficacy at lower concentrations and with shorter exposure times underscores the importance of proper disinfectant use in preventing environmental persistence and transmission in healthcare settings.

PMID 42756048
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PubMedThe Knee2026-09-18

Optimizing perioperative intravenous corticosteroid dosing for postoperative outcomes in total joint arthroplasty: a network meta-analysis.

Kao Pei-En PE, Ker Amy A, Hsu Chih-Wei CW, Shouh Hsu Allen Herng AH et al.

This study aimed to determine the efficacy of different intravenous steroid doses in reducing postoperative pain and rescue antiemetic use in total hip arthroplasty (THA) or total knee arthroplasty (TKA). PubMed, Cochrane Library, and Web of Science were searched through May 2, 2025. Randomized controlled trials (RCTs) of perioperative intravenous steroid doses in adults undergoing primary THA or TKA were included. A frequentist random-effects network meta-analysis was performed. Steroid doses were categorized by dexamethasone-equivalent dosage: Very Low (VL, 1-9 mg), Low (10-19 mg), Intermediate (IM, 20-29 mg), Intermediate-High (IH, 30-39 mg), High (40-49 mg), and Very High (VH, ≥50 mg). Primary outcomes were 24-hour postoperative pain, and rescue antiemetic use. 27 RCTs involving 2,936 participants were identified, with 25 RCTs included in the network meta-analysis. Compared with controls, Low (mean difference [MD]: -2.18; 95% Confidence Interval [CI]: -2.73, -1.63) reduced 24-hour postoperative pain at rest in THA with IM showing borderline significance, whereas VL, Low, and IM were effective in TKA (MDs ranging from -0.68 to -1.14). For 24-hour postoperative pain during movement, Low (MD: -2.13; 95% CI: -2.76, -1.50) and High (MD: -4.30; 95% CI: -5.02, -3.58) most significantly reduced pain in THA, followed by IM and IH, whereas only IM was effective in TKA. Rescue antiemetic use was reduced by 16%-28% in THA and TKA across Low or higher dose groups. Low-dose dexamethasone generally provides adequate benefits, while higher doses may provide additional analgesia in TKA or patients at risk of severe postoperative pain.

PMID 42759157
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