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

Abstract

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.

Emerging threat in antifungal resistance on superficial dermatophyte infection

“…In this present study, the allylamin antifungal (Terbinafin) resistance is nearly comparable to Indian study and triazole antifungal (Fluconazole, Itraconazole) resistance is more or less similar to Dominique and Pramod. [8][9][10] The extent of the problem is variable and depends on the type of fungus, the type of antifungal agents and geographical location of hospital or study area.9 Mukharjee et al in 2003 first confirmed, the report of Terbinafin resistance in superficial fungal infection. 11 Majid et al in their study reported that at the end of 12 weeks there were only 43% enrolled cases which were able to maintain a long term clinical cure after 2 weeks of oral terbinafin 4 but our study showed that in 20.22% cases there was incomple cure and relapse after 2 months of completion of treatment for 01 month.…”

Correlation ofIn VitroSusceptibility Based on MICs and Squalene Epoxidase Mutations with Clinical Response to Terbinafine in Patients with Tinea Corporis/Cruris

“…Although the standard treatment recommendation for tinea corporis/cruris is TRB 250 mg once a day (OD) for 2 to 3 weeks, even lesser treatment durations have been reported to be successful (1)(2)(3). Recently, however, a number of reports have documented clinical failure of TRB treatment (4)(5)(6)(7)(8)(9). High MICs and mutations in the target enzyme, i.e., squalene epoxidase (SQLE), have also been demonstrated among Trichophyton spp.…”

“…in recent reports (8)(9)(10)(11)(12). Consequently, the use of high TRB dosages, in treatment of dermatophytoses, is becoming common (6,13). However, it is important to emphasize that clinical breakpoints have not been defined for TRB in dermatophyt-oses and that the in vitro data cannot be directly applied to clinical situations.…”

Correlation of invitro susceptibility based on MICs and SQLE mutations with clinical response to terbinafine in patients with tinea corporis/cruris

“…(4–7) High minimum inhibitory concentrations (MICs) and mutations in the target enzyme SQLE have been demonstrated in a few recent reports and the use of higher TRB dosages is becoming common. (6,8–13) However, clinical breakpoints have not been defined for TRB in dermatophytoses and the in vitro data cannot be directly applied to clinical situations.…”