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Inappropriate use of oral terbinafine in family practice
Michael Wilcock1, John Hartley, David Gould
1Cornwall & Isles of Scilly Health Authority, John Keay House, St Austell, Cornwall, PL25 4NQ, UK. Mike.Wilcock@ClosHA.Cornwall.nhs.uk
Objective:
To review whether oral terbinafine, used for fungal nail infections, is prescribed appropriately by general practitioners.
Method:
Cross-sectional survey of forty volunteer practices. Prescribing systems were searched to identify patients who had been prescribed a course of oral terbinafine during 1998. The clinical records of five such patients in each practice were examined for additional information regarding appropriate diagnostic tests.
Results:
Five hundred sixty-nine patients (0.25% of the population aged 12 and over) were reported to have received a course of oral terbinafine. Sixty-four percent had been treated empirically without any recorded diagnostic test.
Conclusion:
Treatment of onychomycosis with terbinafine is commonly undertaken without diagnostic confirmation. This empirical treatment does not comply with locally recommended good practice.