An open, randomized, comparative study of oral fluconazole, itraconazole and terbinafine therapy in onychomycosis

Arca, Ercan; Taştan, Halis Bülent; Akar, Ahmet; Kurumlu, Zafer; Gür, Ali Rıza

doi:10.1080/09546630252775171

Cited by 41 publications

(20 citation statements)

References 36 publications

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“…in their study in patients with onychomycosis reported 81.3% clinical cure rate and 75% mycological cure rate with terbinafine. [19] In our survey, terbinafine given for 4 weeks was found to be most effective treatment strategy against superficial dermatophytosis.…”

Section: Discussionmentioning

confidence: 94%

Efficacy and safety of terbinafine 500 mg once daily in patients with dermatophytosis

Babu¹,

Pravin

Deshmukh

et al. 2017

Indian J Dermatol

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Introduction:Dermatophytosis are the most common fungal infections globally. Terbinafine is considered to have good potency against dermatophytes, but resistance to terbinafine is on the rise.Objective:The objective of this study was to evaluate the efficacy and safety of terbinafine 500 mg given once daily in treatment of patients with superficial dermatophytosis.Materials and Methods:It was a retrospective questionnaire-based survey. Each doctor was given survey questionnaire booklet containing survey forms. Clinical response was graded according to the improvement in the affected lesion. Mycological cure was defined as negative microscopy under potassium hydroxide examination and a negative culture in Sabouraud's dextrose agar. Patients were divided into three groups depending on the duration of therapy, Group A – terbinafine 500 mg for 2 weeks, Group B – terbinafine 500 mg for 4 weeks, and Group C – terbinafine 500 mg for 6 weeks.Results:Total 50 doctors completed the survey involving 440 patients. In Group A, out of 194 patients, 87% (n = 169) patients showed very good response. In Group B, out of 211 patients, 92% (n = 194) of the patients showed very good response with >75% improvement in their lesion. In Group C, out of 35 patients, 80% (n = 30) patients showed very good response. Adverse drug reactions of mild to moderate intensity related to terbinafine were seen in 57 patients.Conclusion:Our survey indicates that terbinafine in a dose of 500 mg given once daily was efficacious and safe in the treatment of patients with dermatophytosis.

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Section: Discussionmentioning

confidence: 94%

Efficacy and safety of terbinafine 500 mg once daily in patients with dermatophytosis

Babu¹,

Pravin

Deshmukh

et al. 2017

Indian J Dermatol

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“…Clinical cure rates (21%-38% vs 67%-81%), mycological cure rates (31%-51% vs 75-89%) and overall effi cacy (31% vs 62%) were inferior in fl uconazole treated patients. 135,142 Despite reasonable effi cacy rates, the results of numerous trials indicate that a substantial fraction of onychomycosis patients treated with terbinafi ne remain uncured at the end Terbinafi ne in dermatophytoses of treatment. Consequently several investigations have attempted to address whether additional intrinsic or extrinsic factors infl uence treatment response.…”

Section: Onychomycosismentioning

confidence: 99%

“…In the treatment of distal and lateral subungual onychomycosis restricted to dermatophytes, no appreciable difference was observed between itraconazole (400 mg/day one week "on" three weeks "off ") and terbinafi ne (mycological cure rates: 75%-90% vs 76%-87%, clinical cure rates 53%-82% vs 50%-79%). [135][136][137][138] Not surprisingly, itraconazole demonstrated superior cure rates among the non-dermatophyte moulds (62% vs 44%) and Candida species (92% vs 40%). 138 These studies are contradicted by a large multi-national trial wherein mycological cure rates at 18 months were significantly greater with terbinafine (76%-80%) than observed with pulse-dose itraconazole (38%-49%).…”

Section: Onychomycosismentioning

confidence: 99%

Update on terbinafine with a focus on dermatophytoses

Newland¹,

Abdel‐Rahman

2009

CCID

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Since terbinafi ne was introduced on the world market 17 years ago, it has become the leading antifungal for the treatment of superfi cial fungal infections, aided by unique pharmacologic and microbiologic profi les. This article reviews mode of action, antimycotic spectrum and disposition profi le of terbinafi ne. It examines the data, accumulated over 15 years, on the comparative effi cacy of terbinafi ne (vs griseofulvin, itraconazole, fl uconazole) in the management of the infections for which it is primarily indicated (eg, dermatophytoses) and provides a brief discussion on its use for the treatment of non-dermatophyte infections. Finally, the available data on the newest topical and systemic formulations are introduced.

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“…Less than 50% involvement was defined as mild, 51-75% involvement as moderate, and above 75% as severe [16,17,18]. According to this classification, a mild 10% involvement and 50% involvement are in the same category, despite the fact that 10% involvement is much easier to treat and better results are achieved.…”

Section: Using a Precise Scoring Systemmentioning

confidence: 99%

Variability in Systemic Treatment Efficacy for Onychomycosis: Information That Clinical Studies Do Not Impart to the Office Dermatologist

Shemer¹,

Daniel²,

Rigopoulos³

et al. 2017

Skin Appendage Disord

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Wide differences in the cure rates of onychomycosis in various clinical studies can be avoided if we bear in mind some insights that will help us make study results more consistent. We suggest less rigid criteria in defining the cure rate, the inclusion of all toenails in studies, and the exclusion of nails with a history of trauma. Rather than address patients as a homogenous group, regardless of age, we suggest dividing them into age groups. Researchers should not forget inflammatory diseases that can imply changes on the nails and should take into account the duration of onychomycosis, nail changes caused by asymmetry, and the possibility of dermatophytoma.

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An open, randomized, comparative study of oral fluconazole, itraconazole and terbinafine therapy in onychomycosis

Cited by 41 publications

References 36 publications

Efficacy and safety of terbinafine 500 mg once daily in patients with dermatophytosis

Efficacy and safety of terbinafine 500 mg once daily in patients with dermatophytosis

Update on terbinafine with a focus on dermatophytoses

Variability in Systemic Treatment Efficacy for Onychomycosis: Information That Clinical Studies Do Not Impart to the Office Dermatologist

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