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Related Experiment Videos

Current issues in onychomycosis

E F Trépanier1, G W Amsden

  • 1Department of Pharmacy, Bassett Healthcare, Cooperstown, NY 13326, USA.

The Annals of Pharmacotherapy
|March 13, 1998
PubMed
Summary
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Onychomycosis, a common nail infection, is best treated with continuous terbinafine for dermatophyte cases, offering the most cost-effective solution. Newer antifungals like itraconazole and fluconazole are also options, though terbinafine shows superior efficacy.

Area of Science:

  • Onychomycosis epidemiology and mycology
  • Nail disorder diagnosis and clinical presentation
  • Antifungal pharmacotherapy and pharmacoeconomics

Background:

  • Onychomycosis is a prevalent nail condition significantly affecting patient quality of life.
  • Dermatophytes are the primary causative agents, though yeasts and molds can also be involved.
  • Traditional treatments like griseofulvin have largely been replaced by more effective alternatives due to low cure rates.

Purpose of the Study:

  • To comprehensively review the epidemiology, mycology, clinical features, and diagnosis of onychomycosis.
  • To evaluate current pharmacotherapy options for onychomycosis.
  • To analyze the pharmacoeconomics of onychomycosis treatments.

Main Methods:

  • Conducted a MEDLINE search from 1966 to May 1997.

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  • Collected data from published studies, case reports, manufacturer information, and conference abstracts.
  • Prioritized randomized, controlled comparative trials for pharmacotherapy evaluation, including case series when necessary.

    • Main Results:

    • Diagnosis relies on clinical presentation, KOH preparations, and fungal cultures.
    • Current effective treatments include fluconazole, itraconazole, and terbinafine.
    • Continuous dosing of itraconazole and terbinafine are proven therapies; pulse itraconazole is approved for fingernail infections.

    Conclusions:

    • Continuous terbinafine is the most cost-effective treatment for dermatophyte onychomycosis.
    • Newer azole antifungals are generally well-tolerated but require monitoring for drug interactions.
    • Ongoing research is refining treatment strategies for onychomycosis.