Related Experiment Videos
Open randomized comparison of itraconazole versus terbinafine in onychomycosis
R Arenas1, J Domínguez-Cherit, L M Fernández
1Department of Dermatology, General Hospital Dr. Manuel Gea González, Tlalpan, Mexico.
Background:
Onychomycoses are among the most frequent nail diseases. The principal agents are dermatophytes. Itraconazole and terbinafine are two effective and systemic antimycotics. Previous trials have shown, that treatment schedules with effective concentrations for 3 months cause drug deposits in nail plates that persist 6 months after the end of the treatment.
Methods:
A comparative, open, prospective study was carried out with random assignment of patients. The first group included 27 patients under treatment with 200 mg of itraconazole once daily for 3 months. The second group included 26 patients treated with 250 mg of terbinafine for 3 months. Both series of patients were followed for 6 additional months.
Results:
Both groups were similar in age, sex, and history of onychomycosis. Trichophyton rubrum was the main isolated agent in all patients. The percentage of diseased nails was similar in both groups affecting predominantly the first toenail. Treatment was highly effective and differences between groups were not significant. The rate of adverse events was 21% in the itraconazole group and 47% in the terbinafine group.
Conclusions:
Itraconazole and terbinafine are two drugs of choice in dermatophytic onychomycosis.
Insights
Itraconazole and terbinafine are effective treatments for fungal nail infections (onychomycoses). Both drugs showed similar efficacy, though terbinafine had a higher rate of adverse events in this comparative study.
Area of Science:
- Dermatology
- Mycology
- Pharmacology
Background:
- Onychomycoses are common nail diseases primarily caused by dermatophytes.
- Itraconazole and terbinafine are established systemic antifungal medications for onychomycosis.
- Prior research indicates that effective drug concentrations persist in nail plates for months post-treatment.
Purpose of the Study:
- To compare the efficacy and safety of itraconazole versus terbinafine in treating dermatophytic onychomycosis.
- To evaluate treatment outcomes and adverse events in patients receiving either itraconazole or terbinafine.
Main Methods:
- A prospective, randomized, open-label study involving 53 patients.
- Group 1: 27 patients received itraconazole 200 mg daily for 3 months.
- Group 2: 26 patients received terbinafine 250 mg daily for 3 months. Both groups were followed for 6 months post-treatment.
Main Results:
- Trichophyton rubrum was the predominant fungal agent identified.
- Both treatments demonstrated high effectiveness with no significant differences in clinical outcomes.
- Adverse event rates were 21% for itraconazole and 47% for terbinafine.
Conclusions:
- Itraconazole and terbinafine are both suitable first-line treatments for dermatophytic onychomycosis.
- While effective, terbinafine was associated with a higher incidence of adverse events compared to itraconazole.