Oral therapy with ketoconazole for dermatophyte infections unresponsive to griseofulvin

Oral ketoconazole therapy was evaluated with 21 patients who had recalcitrant dermatophytosis. During an 18-week period, all patients, including three with organisms resistant to griseofulvin in vitro, showed impressive clinical improvement. The four patients without nail involvement became mycologically negative earlier than those with onychomycosis. The latter group showed progressive clearing of the nails, but only three were mycologically clear after 18 weeks. Adverse reactions to ketoconazole were negligible, and no patients required discontinuance of the drug. Ketoconazole appears to be a safe, effective drug for oral therapy of dermatophytoses in humans.