tract mucosa. Phenazopyridine is excreted in the urine  where  it  exerts  a  topical  anesthetic  effect  on the  mucosa  of  the  urinary  tract.  It  is  contrain- dicated   where   renal   insufficiency   exists. Phenazopyridine  imparts  a  bright  red  or  orange color to the urine and the patient should be made aware  of  this  fact. USUAL  DOSE.—  200  mg  three  times  daily after meals. Bacitracin ACTION AND USE.— This bactericide is ef- fective  against  a  wide  variety  of  organisms.  Its mode  of  action  is  the  inhibition  of  bacterial  cell wall  synthesis.  It  is  not  effective  against  most aerobic  gram-negative  bacilli  and  is  employed locally  by  topical  application  in  ointment  form. ANTIFUNGAL Antifungal   agents   inhibit   or   suppress   the growth   systems   of   fungi,   dermatophytes,   or Candida.  Antifungal  have  not  been  developed to the same degree as antibacterial agents. Most fungi  are  completely  resistant  to  the  action  of chemicals at concentrations that can be tolerated by  the  human  cell.  Since  there  are  only  a  few available for internal use, most antifungal agents are  topical.  The  agents  that  are  available  for systemic  use  generally  produce  hepatic  or  renal dysfunction or other serious side effects; because of  this,  systemic  antifungal  should  be  limited  to serious  or  potentially  fatal  conditions.  When  using oral or parenteral antifungal agents, provide con- comitant  therapy  with  topical  preparations. Nystatin (Mycostatin) ACTION AND USE.— Nystatin is primarily used  in  the  treatment  of  candidal  infections.  It is fungicidal and fungistatic against a wide variety of  yeasts  and  yeast-like  fungi  and  most  often  used in  the  treatment  of  candidiasis.  It  is  sometimes used concurrently with tetracycline to suppress the overgrowth  of  Candida  in  the  bowel. USUAL  DOSE.—  Nystatin is available as a cream,  powder,  oral  tablets,  vaginal  tablets,  or oral suspension. The cream or powder should be applied two or three times daily as indicated by clinical  response;  one  or  two  oral  tablets  three times  daily  until  48  hours  after  clinical  cure; vaginal tablets one daily for 2 weeks; and the oral suspension 2 to 4 ml four times daily held in the mouth for as long as possible before swallowing. Griseofulvin (Gris-Peg, Fulvicin) ACTION  AND  USE.—   Griseofulvin  is  a fungistatic agent used in the treatment of fungal infections of the nails, hair, and skin. It is gen- erally reserved for chronic infections that have not responded  to  topical  therapy  alone.  Because  treat- ment  may  last  for  several  months,  the  patient should   be   instructed   to   follow   the   treatment regimen  even  though  symptoms  may  abate.  In- clusion of topical therapy is a must for effective elimination  of  the  infection.  Griseofulvin  is  not indicated for the treatment of superficial fungal infections that can be controlled by topical anti- fungal.  Because  of  its  toxicity,  patients  should have  periodic  evaluations  of  hepatic  and  renal function.  Griseofulvin  is  contraindicated  in  pa- tients  with  hepatic  dysfunction. USUAL DOSE.—  500 mg to 1 g daily as either a  single  dose  or  two  equally  divided  doses. Miconazole  Nitrate  (Monistat) ACTION AND USE.— Miconazole nitrate is a synthetic antifungal that inhibits the growth of common  dermatophytes.  Is  is  indicated  for  the treatment   of   cutaneous   fungal   infections   and vulvovaginal  candidiasis. USUAL  DOSE.—  For  topical  preparations, the cream should be applied to the affected area twice  daily.  For  vaginal  infections,  either  the cream or the suppository should be inserted daily at  bedtime  for  7  days. Undecylenic Acid (Desenex) ACTION  AND  USE.—  This  is  a  fatty  acid antifungal,  available  in  ointment,  dusting  powder, solution,  and  spray.  It  is  used  primarily  in  the treatment  and  prevention  of  tinea  pedis  (athlete’s foot)  and  is  often  compounded  with  zinc  to  act as an astringent. FOR  TOPICAL  USE.—  Apply  two  to  four times daily between the toes and on the affected areas. 7-14