A comparative study on efficacy of oral terbinafine and itraconazole on dermatophytic infections

Abstract

<p><strong>Background:</strong> The increased cases of dermatophyte infections and their poor response to oral drugs with current doses and duration of treatment is common. So, we conducted the study with a goal to assess the efficacies of two antifungal drugs with their increased dosages and duration. </p><p><strong>Methods:</strong> A prospective comparative study was done on 145 patients belonging to age group 18-60 years which were both clinically and microbiologically confirmed cases of tinea cruris and tinea corporis. Patients were randomized into two groups A and B. Group A patients were given capsule itraconazole 100 mg twice daily and group B were given tablet terbinafine 250 mg twice daily, both for 6 weeks. Patients were followed up at 2, 4 and 6 week and at each visit, scores for 3 parameters (erythema, scaling and pruritus) were recorded and were analysed.</p><p><strong>Results:</strong> A total 140 patients completed the study with 72 patients in group A and 73 patients in group B. In group A 72.5% patients achieved complete remission compared to 67.6% in group B. At each follow up patients were evaluated based on total symptom score (erythema, scaling and pruritus) which had shown significant improvement with negative potassium hydroxide results. None of the patients had severe side effects.</p><p><strong>Conclusions:</strong> Study showed that Itraconazole has higher clinical and mycological cure rates as compared to terbinafine. So itraconazole is superior to terbinafine in treatment of tinea corporis and cruris.</p>

Efficacy and Safety of Combination Treatment of Oral Terbinafine and Itraconazole in Patients with Extensive Superficial Dermatophytes

“…This phenomenon is well-established in terbinafine due to its standard dosing regimen of 250 mg daily, that causes accumulation of drug in skin and adipose tissue [9]. This in Patients with Extensive Superficial Dermatophytes underscores that the current standard terbinafine therapy with a 250 mg/day dose may not be sufficient in the present context, whereas resistance of fungus is exacerbated by increased usage, inappropriate prescribing, and over-thecounter sales of antifungal agents [10,11].…”

“…A conjugation therapy utilizing antifungal drugs that acts systemically with definite way of mechanisms has been shown higher cure rates and mitigate resistance of drugs, depending on synergic and additive effects of multiple medicines [1]. The effectiveness of both itraconazole and terbinafine in managing dermatophyte infections has been documented in several studies [7,[11][12][13]. From a clinical perspective, it becomes crucial for clinicians to assess the comparative efficacy of these two drugs in standard clinical scenarios.…”

Efficacy and Safety of Combination Treatment of Oral Terbinafine and Itraconazole in Patients with Extensive Superficial Dermatophytes

“…One of the primary mechanisms behind antifungal resistance is a decrease in effective drug concentration [17]. This phenomenon is well-established in terbinafine due to its standard dosing regimen of 250 mg daily, that causes accumulation of drug in skin and adipose tissue.9 This underscores that the current standard terbinafine therapy with a 250 mg/day dose may not be sufficient in the present context, where as resistance of fungus is exacerbated by increased usage, inappropriate prescribing, and over-the-counter sales of antifungal agents [10,11].…”

“…Utilizing a combination therapy involving systemic antifungal drugs with distinct mechanisms of action has been shown to improve cure rates and mitigate drug resistance, relying on the synergistic and additive effects of multiple drugs [1]. The effectiveness of both itraconazole and terbinafine in managing dermatophyte infections has been documented in several studies [7,[11][12][13]. From a clinical perspective, it becomes crucial for clinicians to assess the comparative efficacy of these two drugs in standard clinical scenarios.…”

So Sánh Kết Quả Điều Trị Bệnh Nấm Thân Mình Bằng Uống Itraconazole Và Terbinafine Tại Bệnh Viện Da Liễu Trung Ương

“…Trong một nghiên cứu của Singh và cộng sự, khi so sánh Terbinafine (250 -500 mg/ngày trong 2 -6 tuần) và Itraconazole (100 -200 mg/ngày trong 2 -4 tuần), với các liều khác nhau, cũng cho kết quả là Itraconazole có hiệu quả hơn 15 . Một số nghiên cứu khác cũng cho thấy Itraconazole có hiệu quả cao hơn Terbinafine trong điều trị nấm thân mình 16,17,18 . Tuy nhiên, cũng có một số nghiên cứu chỉ ra rằng không có sự khác biệt giữa hai loại thuốc về hiệu quả điều trị, hoặc có một số nghiên cứu cho kết quả trái ngược, terbinafine có hiệu quả hơn Itraconazole 19,20 Hơn nữa, 10 chủng T. interdigitale (MIC 0,125 -2 μg/mL) có kiểu gen hoang dã.…”