Comparison of efficacy and safety of oral fluconazole and topical clotrimazole in the treatment of tinea corporis, tinea cruris, tinea pedis, and cutaneous candidiasis

Abstract

The safety and efficacy of oral fluconazole 150 mg once weekly were compared with those of topical clotrimazole 1% cream twice daily in the treatment of tinea corporis, tinea cruris, tinea pedis, and cutaneous candidiasis. A total of 391 patients were enrolled in 19 centers in 12 countries. Treatment lasted 2 to 4 weeks for patients with tinea corporis, tinea cruris, or cutaneous candidiasis, and up to 6 weeks for patients with tinea pedis. Fluconazole and clotrimazole were relatively comparable in clinical outcome in nearly all infections at the end of therapy and at the long-term follow-up visit (28 to 35 days after the last dose). No statistically significant between-group difference was observed in the rate of eradication of the original pathogen for tinea corporis, tinea cruris, or cutaneous candidiasis. For tinea pedis, however, fluconazole was less effective than clotrimazole. Safety profiles were comparable in the two treatment groups—both agents were well tolerated with minimal adverse events. Results of this trial demonstrated that oral fluconazole 150 mg once weekly and topical clotrimazole 1% cream twice daily are comparable in safety and efficacy for the treatment of certain superficial fungal infections. In addition, fluconazole provides convenient once-weekly dosing, which may lead to greater patient compliance.