Terbinafine in onychomycosis with involvement by non-dermatophytic fungi

Sixty-five patients with onychomycosis involving the yeasts Candida albicans or C. parapsilosis, or the mould Scopulariopsis brevicaulis, were treated for up to 48 weeks with terbinafine 250 mg daily. At the end of therapy mycological and clinical cure rates were 70% and 54% for C. albicans, and 85% and 63% for C. parapsilosis, respectively. Three out of seven S. brevicaulis infections were cured. Within 6 months of therapy, relapses occurred in 45.5% of the cured patients in the case of C. albicans infections and in 12.5% of the cured patients in the case of C. parapsilosis infections. Treatment was generally well tolerated and, although adverse events occurred in 43% of the patients, they were responsible for cessation of therapy in only 8.6%. These results indicate that the use of terbinafine in onychomycosis is not restricted to dermatophyte infections.