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clotrimazole + betamethasone (Flotiran / Lotrisone / Lotricomb)

✓ Approved

Merck & Co. · NR3C1 · Small Molecule

What is clotrimazole + betamethasone?

clotrimazole + betamethasone is a small molecule developed by Merck & Co.. It is approved for therapeutic indications via unknown.

Drug Profile

Brand NamesFlotiran, Lotrisone, Lotricomb
CompanyMerck & Co.
Drug ClassSmall Molecule
Molecular TargetNR3C1,
RouteUnknown
StatusApproved
Sources: ClinicalTrials.gov, Merck & Co.

Mechanism of Action

Molecular Targets

clotrimazole + betamethasone acts on 2 molecular targets:

NR3C1nuclear receptor subfamily 3 group C member 1 (GR, GCCR)
sterol demethylase, Candida albicans (ERG11)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

clotrimazole + betamethasone is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Infections and infestationsWound infection fungal✓ Approved

Related Research Articles

PubMedMedical mycology2026-11-10

Avian Dermatophytosis Caused by Lophophyton gallinae in Thailand: Emergence in a Broiler Breeder Farm and Surrounding Community, Multilocus Molecular Characterization, and Antifungal Susceptibility.

Dachakul Nirawit N, Jenjirawatn Koramit K, Punperm Purun P, Thamprisarn Rapeewan R et al.

Avian dermatophytosis, caused by the zoophilic dermatophyte Lophophyton gallinae, is a neglected superficial mycosis. This study explored an outbreak across a commercial broiler breeder farm and neighboring backyard poultry flocks in Thailand. A total of 133 samples were collected for dermatophyte culture, comprising suspected chicken samples from broiler breeder farms (n = 89) and three backyard flocks around outbreak farms (n = 29), along with environmental samples from outbreak farms (n = 15). L. gallinae was isolated and morphologically identified from 40 birds, comprising 32/89 broiler breeders (36.0%) and 8/29 backyard poultry samples (27.6%). All environmental samples were negative for dermatophyte culture. To determine their phylogenetic relationships and genetic diversity, 10 representative positive isolates were subjected to single-locus sequence analysis of the internal transcribed spacer (ITS) region and concatenated multilocus sequence analyses of the combined ITS and partial β-tubulin (TUB2) loci. Phylogenetic inference revealed that the L. gallinae clade diverges into two groups associated with avian and nonavian hosts, with all Thai isolates clustering specially within the avian-associated group. Furthermore, in vitro antifungal susceptibility testing of 40 isolates revealed low minimum inhibitory concentration (MIC) values across all tested agents, with MIC ranges of < 0.016-0.125 µg/mL for enilconazole, <0.03-0.25 µg/mL for clotrimazole, 0.03-0.25 µg/mL for itraconazole, and < 0.125-1.00 µg/mL for griseofulvin. Overall, this study represents the first report of a severe L. gallinae outbreak within a commercial poultry farm in Thailand and provides molecular characterization of the L. gallinae clade within the Arthrodermataceae family.

PMID 43008276
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PubMedObstetrics and gynecology2026-11-10

Hospital-Level Variation in Antenatal Corticosteroid Use for Late Preterm Births.

Clapp Mark A MA, Lee Dohyun D, Li Siguo S, James Kaitlyn E KE et al.

To determine whether and to what extent hospitals across the United States vary in their use of late preterm steroids. This was a retrospective cohort study of singleton births with known gestational ages identified in the Premier Healthcare Database from 2015 to 2022. The primary variable of interest was hospital-level adoption of antenatal corticosteroid use for late preterm singleton deliveries, calculated as the proportion of late preterm singleton births (34-36 completed weeks of gestation) with any betamethasone exposure during the same late preterm period. Hospital adoption was defined as the weighted average rate of steroid administration among late preterm births across the entire postperiod. Hospitals were ranked by their late preterm steroid adoption rates and categorized by quartile based on the empirical distribution. Temporal trends were assessed using annual hospital-level adoption rates and visualized using time series plots and distributional plots. A logistic regression model was constructed to identify hospital characteristics associated with being a highest-quartile adopter. The analysis cohort included 726 hospitals and 5,109,270 births, of which 309,837 (6.1%) were singleton late preterm births. Hospital steroid exposure rates ranged from 0% to 92% and were categorized into quartiles based on overall exposure rate, with cutoffs at 22.4%, 33.9%, and 45.1%. Median exposure rates increased progressively across quartiles, from 15.4% (IQR 10.0-18.9%) in the lowest-adopting hospitals (quartile 1) to 54.3% (IQR 49.1-61.0%) in the highest-adopting hospitals (quartile 4), with substantial within-quartile variation. In the multivariable model, urban location was a strong predictor of high adoption after adjustment (adjusted odds ratio [aOR] 2.03; 95% CI, 1.04-4.02, P=.04). Compared with Midwestern hospitals, Southern hospitals had significantly lower odds of being high adopters (aOR 0.32; 95% CI, 0.17-0.61, P<.001). Among clinical case mix variables, a higher proportion of late preterm births at 34 weeks of gestation was strongly associated with high adoption (aOR 2.39; 95% CI, 1.73-3.36, P<.001). After the publication of the ALPS (Antenatal Late Preterm Steroids) trial, the adoption of late preterm steroid use was heterogeneous among U.S. hospitals. These findings highlight the need for a more in-depth exploration of local factors that drive the adoption of evidence-based practices outside of observable hospital characteristics.

PMID 43008238
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PubMedBMC anesthesiology2026-11-10

Erector spinae plane block in a patient with post-thoracotomy pain syndrome and intercostal neuralgia presenting with late-onset myoclonus: a case report.

Altunbag Yavuz Eda E, Seker Dincer Firat DF, Bayram Mustafa Gokhan MG, Yavuz Adil Ugur AU

Post-thoracotomy pain syndrome (PTPS) is a complex post-surgical chronic pain condition of the chest wall involving neuropathic, nociceptive, and nociplastic components, with intercostal neuralgia contributing in some cases. Intercostal neuralgia may occasionally present with motor manifestations, although such presentations have been infrequently described in the literature. Management of chronic PTPS remains challenging, particularly in cases refractory to medical therapy. The erector spinae plane block (ESPB) has been described as a regional analgesia technique in acute and chronic thoracic pain; however, its role in PTPS associated with motor symptoms has not been well defined. We report the case of a 60-year-old male who presented with severe chronic neuropathic pain in the left hemithorax seven years after undergoing a left posterolateral thoracotomy for lung mass excision. The pain was accompanied by late-onset myoclonus localized to the intercostal nerve distribution. Physical examination revealed hyperalgesia and high-frequency muscle spasms along the left T2-T6 dermatomes, with pain intensity rated as 8-9/10 on the Numeric Rating Scale (NRS; 0 = no pain, 10 = worst imaginable pain). Imaging studies showed expected postsurgical changes of the chest wall, without evidence of additional structural pathology contributing to the patient's symptoms. Differential diagnoses, including herpes zoster infection and thoracotomy-related long thoracic and thoracodorsal nerve injuries, were considered less likely based on the clinical findings. With a preliminary diagnosis of PTPS and intercostal neuralgia, ultrasound-guided ESPB was performed at the T4 level using bupivacaine, lidocaine, and dexamethasone. Significant reduction in pain scores (NRS 1-2/10) and muscle spasm frequency was observed within 15 min. Due to recurrence of symptoms after 24 h, a second ESPB using bupivacaine and betamethasone was performed, followed by near-complete resolution of pain (NRS 0-1/10) and disappearance of muscle spasms. No complications were observed. The patient was discharged with oral neuropathic pain medication and referred for outpatient pain management follow-up. Telephone follow-up demonstrated significant symptom improvement for approximately three weeks. This case describes the use of ultrasound-guided ESPB in a patient with PTPS and intercostal neuralgia accompanied by late-onset myoclonic symptoms. ESPB was followed by rapid improvement in pain and reduction in involuntary muscle spasms. These observations may support further discussion of the possible role of ESPB in selected patients with PTPS, intercostal neuralgia, and associated motor manifestations.

PMID 43004169
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PubMedbioRxiv : the preprint server for biology2026-11-06

Adaptive responses to antifungal selection depend on dose and drug combination in experimentally evolved yeast.

Sandoval-Powers Megan M, Crestani Giovanni G, Dugo Hannah H, Shearman Ellery E et al.

Natural populations rarely face a single stressor at a single intensity, yet most laboratory evolution experiments impose exactly that. Theory predicts that stronger or compounded selection pressures should change the magnitude of adaptive change as well as the specific loci involved, but this prediction is rarely tested directly. Here, we use an evolve-and-resequence approach to compare genomic responses in Saccharomyces cerevisiae across antifungal environments differing in the concentration and number of drugs applied. Twelve replicate populations founded from a genetically diverse ancestor were evolved for >50 generations under low and high concentrations of caspofungin or clotrimazole alone, a combination of the two drugs, or no drug, with pooled-population sequencing at three timepoints. We found little overlap among candidate loci between concentrations of the same drug or between single and combined treatments. Alleles favored in one environment did not shift predictably in the others, departing from expectations of additivity. We also observed that most candidate loci fell outside known antifungal resistance genes, except for FKS1 in all caspofungin treatments and a putative gain of the ERG11 -containing chromosome VIII in 9 of 12 populations evolved under high clotrimazole. Remaining candidates implicated diverse cellular functions that differed among environments. Furthermore, we found little evidence of fitness costs in drug-free medium across all evolved populations. Our results collectively show that stronger and combined antifungal selection redirects genomic responses rather than simply amplifying those favored under less challenging conditions, highlighting the limits of predicting adaptation from simpler selection regimes. Predicting evolutionary responses across environmental contexts remains a major challenge. Populations exposed to similar stresses often show repeatable patterns of adaptation, but whether these patterns persist as stress intensifies or multiple stresses occur together is less clear. By evolving yeast under different concentrations of two antifungal drugs, alone and in combination, we found that the genetic changes responding to selection differed substantially across treatments. Stronger and combined antifungal selection favored distinct genomic responses beyond the drugs' primary targets, while retaining some shared responses at known resistance-associated loci. These findings show that evolutionary responses observed under one set of conditions may be poor predictors of adaptation under stronger or more complex stress, with implications for anticipating antimicrobial resistance across different drug concentrations and combination therapies.

PMID 42990291
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PubMedDrug delivery and translational research2026-11-04

Development and evaluation of a microneedle-assisted transdermal delivery system for compound betamethasone in atopic dermatitis.

Wang Si-Ning SN, Qiao Xiaojing X, Du Fangzhi F, Chen Jing J et al.

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by skin barrier dysfunctio​n and immune dysregulation, which may influence topical drug penetration and therapeutic efficacy. This study evaluated a microneedle-assisted approach to enhance the cutaneous delivery of compound betamethasone in AD. Franz diffusion cell experiments demonstrated 3.29-fold and 4.67-fold increases in the 24-h cumulative permeation of betamethasone dipropionate (BDP) and betamethasone sodium phosphate (BSP), respectively, compared with passive application. In vivo fluorescence imaging showed greater penetration depth of fluorescein sodium following microneedle treatment, while histological examination revealed transient epidermal disruption. In a 2,4-dinitrochlorobenzene (DNCB)-induced AD mouse model, the combined treatment was associated with reduced epidermal thickening, mast cell accumulation, and serum IgE and IL-13 levels. In a pilot split-body clinical study involving 28 participants with mild-to-moderate AD, the microneedle + compound betamethasone-treated side showed greater improvements in Scoring Atopic Dermatitis (SCORAD) intensity and numeric rating scale (NRS) pruritus scores than the contralateral microneedle + saline control side after 7 days. No serious adverse events were observed during the study period. These findings demonstrate enhanced cutaneous permeation of compound betamethasone following microneedle-assisted application and provide preliminary evidence of therapeutic activity and short-term tolerability in AD.

PMID 42981018
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PubMedBMC veterinary research2026-11-04

Isolation, identification and antifungal resistance profile of toxigenic Aspergillus species from marketed dog foods in Ibadan, Nigeria.

Adeyemo Ismail Adewuyi IA, Ahmed Akeem Olayiwola AO, Isola Tajudeen Opeyemi TO, Aremu Abdulfatai A et al.

Mycotoxin-producing fungi that contaminate dog food have effects on the feed's nutritional value, organoleptic characteristics, and overall quality. Animals and humans may experience both short-term and long-term harmful effects by consuming fungi and mycotoxin-contaminated feeds. In dogs, high morbidity and mortality are observed as a result of immunosuppressive, hepatotoxic, nephrotoxic, and carcinogenic effects from the mycotoxins. This study investigated the occurrence, antimicrobial resistance profile and mycotoxins produced by toxigenic Aspergillus species, with the potential aim of providing baseline information on the quality and safety of commercial dog feeds. Eighteen brands/types of dog food samples were obtained from pet and veterinary stores in Ibadan, Oyo State. Two main species of presumptive toxigenic Aspergillus were isolated and identified by using both macroscopic examination and standard microbiological procedures. Antifungal susceptibility test (AFST) was carried out using the disc diffusion method to determine resistance profiles of these presumptive isolates (n=14). The GC-MS analytical method was used to screen 10 selected dog foods for 16 different mycotoxins. Sixteen (88.9%) samples were presumptively positive for Aspergillus species. All (100%) crunchies (imported), noodles and mash types of dog food samples were positive for Aspergillus species. While two out of the three local crunchies and one out of the spaghetti types of the dog food were positive for Aspergillus species. Seven (39%) and 16 (89%) isolation rates were recorded for presumptive Aspergillus parasiticus and Aspergillus flavus, respectively. A varying degree of resistance was observed among the selected isolates to Miconazole, Ketoconazole, Clotrimazole and Nystatin. However, 100% of the 14 isolates showed resistance to Flucytosine and Fluconazole, while 100% of the selected isolates were sensitive to Econazole. Seven different resistance patterns were observed for the 14 isolates of both Aspergillus parasiticus and Aspergillus flavus, with 85.7 % Multiple drugs resistance (MDR). Nine mycotoxins (Aflatoxins B1, G1, G2, M1, M2, Fumonisin B2, Ochratoxin A, T2-toxin and H2-toxin) were detected and higher levels for seven of the mycotoxins (Aflatoxins B1, G1, G2, M1, M2, Ochratoxin A and T2-toxin) were observed. This study isolated toxigenic Aspergillus spp that are resistant to standard antifungal drugs with high mycotoxin contamination in dog foods marketed in Ibadan.

PMID 42977943
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