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Onychomycosis in children: treatment with bifonazole-urea
1Mycology Department, Dermatology Service, Hospital General de Mexico, and Pediatric Dermatology Service, Hospital Infantil de Mexico, Mexico City, Mexico. bonayalx@servidor.unam.mx
Insights
A two-phase topical treatment using bifonazole-urea effectively treated onychomycosis in children. This safe antifungal regimen achieved a 68% cure rate in pediatric patients with nail fungus infections.
Area of Science:
- Dermatology
- Mycology
- Pediatric Medicine
Background:
- Onychomycosis, a fungal nail infection, affects children.
- Limited safe and effective treatment options exist for pediatric onychomycosis.
Purpose of the Study:
- To evaluate the safety and efficacy of a two-phase topical treatment for pediatric onychomycosis.
- To assess a novel bifonazole-urea ointment and bifonazole cream regimen.
Main Methods:
- A study involving 25 children under 16 with confirmed onychomycosis.
- Phase 1: Bifonazole-urea ointment under occlusion for nail removal.
- Phase 2: Bifonazole cream application for 4 weeks, followed by 4-week follow-up.
Main Results:
- A 68% cure rate (17/25 patients) was achieved.
- 6 patients showed improvement, and 2 experienced treatment failure.
- Trichophyton rubrum was the primary causative agent (92%).
- Minor side effects (mild pain, dermatitis) occurred in two patients, not requiring treatment discontinuation.
Conclusions:
- The two-phase bifonazole-urea treatment is safe and effective for pediatric onychomycosis.
- This regimen offers a new therapeutic option for children with fungal nail infections.
- High efficacy against Trichophyton rubrum was observed.
Abstract:
We assessed the safety and efficacy of a two-phase topical treatment with bifonazole-urea ointment in children with onychomycosis. Twenty-five children younger than 16 years old with proved onychomycosis were included in the study. Bifonazole-urea ointment was administered under occlusion until the nontraumatic removal of the nail was achieved. Bifonazole cream was then applied for 4 weeks and a follow-up visit 4 weeks after cessation of medication was scheduled. During the study, periodic clinical and mycologic evaluations were carried out. Of the 25 patients included, 17 were cured (68%), 6 improved, and 2 failed treatment. The main etiologic agent isolated was Trichophyton rubrum (92%). Two patients had minor side effects, both during the occlusive phase, one each with mild pain and a probable dermatitis from the adhesive strips. Treatment was not discontinued in both of these cases. We concluded that a two-phase treatment with bifonazole-urea is effective and safe, and represents a new therapeutic choice for onychomycosis in children.