Treatment of dermatophyte nail infections: An open randomized study comparing intermittent terbinafine therapy with continuous terbinafine treatment and intermittent itraconazole therapy*

https://doi.org/10.1016/S0190-9622(96)80057-0Get rights and content

Background:

Terbinafine persists in the nail at effective concentrations for several weeks after discontinuation of treatment.

Objective:

Our purpose was to verify whether intermittent terbinafine therapy is effective in dermatophytic onychomycosis and to compare the results of intermittent terbinafine with those of intermittent itraconazole and continuous terbinafine treatment.

Methods:

An open, randomized study of 63 patients was performed with three treatment regimens: terbinafine, 250 mg daily (21 patients); terbinafine, 500 mg daily for 1 week every month (21 patients); or itraconazole, 400 mg daily for 1 week every month (21 patients). Treatment was continued for 4 months in toenail infections (60 patients) and 2 months in fingernail infections (3 patients).

Results:

At the end of the follow-up period (6 months after discontinuation of treatment) 16 of 17 patients (94.1%) with toenail onychomycosis were mycologically cured in the terbinafine 250 mg group, 16 of 20 (80%) in the terbinafine 500 mg group, and 15 of 20 (75%) in the itraconazole group.

Conclusion:

The percentage of patients who were mycologically cured was higher in the continuous terbinafine group than in the intermittent terbinafine and itraconazole groups, but statistical analysis did not reveal any significant difference between these cure rates.

References (13)

  • HanekeE et al.

    Short-duration treatment of fingernail dermatophytosis: a randomized, double-blind study with terbinafine and griseofulvin

    J Am Acad Dermatol

    (1995)
  • BalfourJA et al.

    Terbinafine: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in superficial mycoses

    Drugs

    (1992)
  • La PlacaM et al.

    Terbinafine vs griseofulvin in the treatment of onychomycosis due to dermatophytes

    G Ital Dermatol Venereol

    (1994)
  • VillarsB et al.

    Present status of efficacy and tolerability of terbinafine (Lamisil) used systemically in the treatment of dermatomycosis of skin and nails

    J Dermatol Treat

    (1990)
  • FaergemannJ et al.

    Levels of terbinafine in plasma, stratum corneum, dermis-epidermis (without stratum corneum), sebum, hair and nails during and after 250 mg terbinafine orally once daily for 7 and 14 days

    Clin Exp Dermatol

    (1994)
  • DykesPJ et al.

    Determination of terbinafine in nail samples during systemic treatment of onychomycosis

    Br J Dermatol

    (1990)
There are more references available in the full text version of this article.
*

Supported in part by Sandoz PF, Milan, Italy.

View full text