Onychomycosis in children: Safety and efficacy of antifungal agents

Gupta, Aditya K.; Mays, Rachel; Versteeg, Sarah G.; Shear, Neil H.; Friedlander, Sheila Fallon

doi:10.1111/pde.13561

Cited by 32 publications

(38 citation statements)

References 32 publications

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“…Very few clinical trials have been published on the efficacy and safety of onychomycosis treatments in children with preliminary evidence suggesting currently available onychomycosis treatments are effective and appear safe to use in children . Dosing regimens must be readjusted according to the child's weight .…”

Section: Special Populationsmentioning

confidence: 99%

“…68 Very few clinical trials have been published on the efficacy and safety of onychomycosis treatments in children with preliminary evidence suggesting currently available onychomycosis treatments are effective and appear safe to use in children. 69 Dosing regimens must be readjusted according to the child's weight. 67,70 As the pharmacokinetics of antifungals are generally different in children versus adults, understanding the adverse effects associated with antifungal medications is an important factor in appropriately managing fungal infections.…”

Section: Childrenmentioning

confidence: 99%

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Global perspectives for the management of onychomycosis

et al. 2018

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Onychomycosis is a fungal nail infection caused by dermatophytes, nondermatophyte molds, and yeasts. This difficult‐to‐treat chronic infection has a tendency to relapse despite treatment. This paper aims to offer a global perspective on onychomycosis management from expert physicians from around the world. Overall, the majority of experts surveyed used systemic, topical, and combination treatments approved in their countries and monitored patients based on the product insert or government recommendations. Although the basics of treating onychomycosis were similar between countries, slight differences in onychomycosis management between countries were found. These differences were mainly due to different approaches to adjunctive therapy, rating the severity of disease and use of prophylaxis treatment. A global perspective on the treatment of onychomycosis provides a framework of success for the committed clinician with appreciation of how onychomycosis is managed worldwide.

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Section: Special Populationsmentioning

confidence: 99%

Section: Childrenmentioning

confidence: 99%

Global perspectives for the management of onychomycosis

et al. 2018

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“…This may be attributed to many factors such as thinner and faster growing nails in children compared to adults, better patient compliance to the topical treatment with the external help of parents or guardians, faster elimination of fungal pathogen, lower possibility of cumulative nail trauma or damage and better peripheral perfusion. 13,14 The topical administration of efinaconazole topical solution, 10%…”

Section: Discussionmentioning

confidence: 99%

“…25 It is therefore important to treat the tinea pedis with an effective agent when treating the toenails with a topical solution. 3,13 With both ciclopirox 8% nail lacquer topical solution 26 and efinaconazole topical solution 10% 27 it has been observed that the treatment of tinea pedis results in better response to the topical nail solution being used to treat the onychomycosis. Additionally, if the parents or close contacts have onychomycosis or tinea pedis treatment should be considered.…”

Section: Discussionmentioning

confidence: 99%

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Labeled use of efinaconazole topical solution 10% in treating onychomycosis in children and a review of the management of pediatric onychomycosis

Gupta

Venkataraman

Shear

et al. 2020

Dermatologic Therapy

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Onychomycosis is a difficult to treat condition whose prevalence is increasing. Until recently, there was no FDA approved antifungal agent for the treatment of onychomycosis in children. Although systemic antifungal agents are effective, their use is restricted by the potential adverse events and drug‐drug interactions. There is evidence regarding the safety and efficacy of topical antifungal agents for pediatric onychomycosis. We have summarized the results of a recently published study using efinaconazole topical solution 10% to treat onychomycosis in children and discuss management of pediatric onychomycosis. In a multicenter, open‐label phase 4 study, efinaconazole 10% solution was applied topically once daily in children aged 6 to 16 years with mild to severe, culture positive, distal and lateral subungual onychomycosis. Treatment was for 48 weeks with a follow‐up at week 52. Pharmacokinetics was performed in a subset of patients. There were 62 patients enrolled in the study. At week 52, the efficacy was mycological cure rate 65% and complete cure rate 40%. All treatment‐emergent adverse events (TEAE) were mild to moderate in severity with none resulting in study discontinuation. The only treatment‐related TEAE was ingrown toenail. Efinaconazole was detected at low levels in plasma. Efinaconazole topical solution 10% is effective and safe in treating onychomycosis in children age 6 to 16 years and was recently FDA‐approved for this indication. The on‐label use of other topical agents, tavaborole solution 5% and ciclopirox nail lacquer solution 8% is reviewed. We also briefly discuss the use of oral agents, terbinafine, itraconazole, and fluconazole in pediatric onychomycosis.

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