The Activity of Ketoconazole in the Treatment of Onychomycosis

Galimberti, Ricardo; Negroni, Ricardo; Costa, María A.; Casalá, A. M.

doi:10.1093/clinids/2.4.596

Cited by 28 publications

(6 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Davies et al [1] recorded only 3% clinical cures and 29% mycological cures of patients treated with long-term griseofulvin for this disorder. This high failure rate has discouraged the use of griseofulvin [1,2], Recently, promising results have been obtained on the antimycotic effect of orally administered ketoconazole [3], but further clinical studies are necessary before evaluating its place in the therapy of onychomycoses.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Onychomycosis by Partial Nail Avulsion and Topical Miconazole

Rollman¹

1982

Dermatology

View full text Add to dashboard Cite

13 patients with distal subungual onychomycosis in a total of 48 dermatophyte-infected nails were treated with chemomechanical, partial nail avulsion followed by topical miconazole for 8 weeks. On examination, 6 months after cessation of therapy, 42% of the nails were cured by clinical and mycological criteria. The therapeutic response was related to the pretreatment extension of subungual hyperkeratosis. Periungual skin irritation was common during the initial avulsion period. Miconazole solution was well tolerated and this treatment modality proved to be a valuable alternative to other remedies for the treatment of onychomycosis limited to a few number of nails.

show abstract

Section: Introductionmentioning

confidence: 99%

Treatment of Onychomycosis by Partial Nail Avulsion and Topical Miconazole

Rollman¹

1982

Dermatology

View full text Add to dashboard Cite

show abstract

“…Some years ago, the imidazole derivative ketoconazole was discussed as an alternative for the treatment of tinea unguium (3,14,25). Later, safety concerns made the drug obsolete for that indication (2,8).…”

mentioning

confidence: 99%

Treatment of tinea unguium with medium and high doses of ultramicrosize griseofulvin compared with that with itraconazole

Körting

Schäfer‐Korting

Zienicke

et al. 1993

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Toenail tinea is a very recalcitrant dermatosis. Griseofulvin at 2500 mg/day is the current medication of choice, but it is minimally successful. In a controlled open trial ultramicrosize griseofulvin (UMSG) at doses of 660 and 990 mg/day was compared with itraconazole at 100 mg/day in 109 patients. At 4-week intervals, the patients were evaluated for their clinical and mycological statuses and adverse reactions. Treatment was given for up to 18 months. Compliance was checked by tablet counting. Response (cure, partial cure, marked improvement) was analyzed by the intent-to-treat method. Cured and partially cured patients were followed up. Except for one early dropout, the toenails (mean, 6 to 7) were involved. Cure or partial cure was found in 6% (UMSG at 660 mg), 14% (UMSG at 990 mg), and 19%o (itraconazole at 100 mg) of patients (P = 0.2097); marked improvement was found in 36, 44, and 39%o of patients in the three treatment groups, respectively.Most patients had to be treated for 18 months. Failure was related to short medication periods (adverse drug reactions, dropout). While stable cure was not obtained with UMSG at 660 mg, the higher dose of UMSG and itraconazole gave stable cures in the other patients. Side effects of nausea, diarrhea, and headache were found in 20, 26, and 11 patients, respectively (P = 0.0028), and the numbers in whom medication had to be discontinued differed, too (P = 0.0137). While there was no major difference with glutamic-pyruvic transaminase and -y-GT, total and low-density lipoprotein cholesterol levels declined slightly in the itraconazole group (P = 0.0357 and P = 0.0639, respectively, at 3 months). More than 70% of the patients had an average compliance of .90o%; four patients (two dropouts) were poor compliers. In conclusion, it appears questionable whether griseofulvin can continue to be considered the "gold standard" in the treatment of toenail tinea. At present, itraconazole at 100 mg shows better efficacy and is better tolerated.

show abstract

“…Galimberti et al [4] achieved 67% cure after an average treat ment period of l'h months with ketocon azole alone. Hay and Clayton [7], however, found that only 18% of patients with sole and toenail dermatophytic infections were cured even after 18 months.…”

Section: Discussionmentioning

confidence: 99%

“…Griseofulvin treatment has at best brought about a cure in 17% [1], Even treatment periods of 1-2 years have been unsuccessful and true resistance of dermatophytes to griseofulvin has also been reported [2], Kétoconazole (imidazole derivative) has recently been introduced as an oral, broad-spectrum and efficient anti fungal drug [3]. Treatment must be contin ued for several months because toenails are slow-growing [4], Liver complications may occur even after short periods of kétocon azole therapy [3,5]. We therefore felt it val uable to study the effect of partial removal of the infectious focus, combined with a shorter course of kétoconazole treatment.…”

Section: Introductionmentioning

confidence: 99%

<i>Trichophyton</i>-<i>rubrum</i>-lnfected Toenails Treated with Ketoconazole and Partial Nail Avulsion

Kavli¹,

Midelfart²,

Moseng³

et al. 1984

Dermatology

View full text Add to dashboard Cite

30 patients with totally 178 toenails infected with Trichophyton rubrum were randomly treated with ketoconazole alone for 4 months (group A) or in combination with chemical nail avulsion (group B). Of the 14 patients in group A who completed the treatment, 4 (28%) were cured 6 months later, compared to 8 (53%) of 15 patients in group B. In 4 cases, transient elevated hepatofunction enzymes occurred. Gastrointestinal disturbances caused withdrawal in 1 case.

show abstract

The Activity of Ketoconazole in the Treatment of Onychomycosis

Cited by 28 publications

References 1 publication

Treatment of Onychomycosis by Partial Nail Avulsion and Topical Miconazole

Treatment of Onychomycosis by Partial Nail Avulsion and Topical Miconazole

Treatment of tinea unguium with medium and high doses of ultramicrosize griseofulvin compared with that with itraconazole

<i>Trichophyton</i>-<i>rubrum</i>-lnfected Toenails Treated with Ketoconazole and Partial Nail Avulsion

Contact Info

Product

Resources

About