Increased fluconazole usage by dermatologists in the Medicare provider utilization and payment database, 2014-2019

Abstract

To the Editor: We thank Davis and Davis for their interest in our paper analyzing utilization, cost, and prescription trends of onychomycosis medications among Medicare patients.1 We chose to focus on United States Food and Drug Administration–approved antifungals for onychomycosis treatment in our research letter.1 We agree with the authors that oral fluconazole is an effective and safe off-label antifungal for onychomycosis treatment. Our senior author uses this drug in her practice routinely to treat cases of terbinafine failure and for patients with mixed infections of dermatophytes and Candida spp.