Abstract
Therapeutic options for onychomycosis include oral and topical antifungals. Since topical medicines are used both in monotherapy, and in combination therapy, the aim of this work was to conduct comparative analysis of topical preparations for treatment of onychomycosis included into clinical protocol and State Formulary of Ukraine. comparative analysis of topical medicines included into clinical protocol and State Formulary of Ukraine, 10th edition. Clinical protocol for treatment of onychomycosis (CP) was approved by Ministry of Health of Ukraine in 2012. It recommends three onycholytic preparations with urea to remove infected nail plate, and than to treat a nail bed with either antifungal lacquer or topical preparation with ketoconazole, terbinafine, oxiconazole, miconazole, chlornitrophenol, undecylenic acid, combination preparation with ketoconazole and salicylic acid. The last preparations are listed without indication of a preferred dosage form. State Formulary of Ukraine, 10th (SFU) was approved by Ministry of Health of Ukraine in 2018. SFU also recommends applying antifungals onto nail bed after nail plate removal, but it does not recommend any onycholytic preparations. Furthermore, among 42 topical antifungal preparations included into SFU, only four antifungals are recommended for onychomycosis treatment. These are bifonazole cream, econazole cream, gel and cream with miconazole. Neither ketoconazole nor other topical antifungal preparation listed in CP, except of miconazole, are specified by SFU to be effective for onychomycosis. Antifungal lacquers are not included into SFU at all. There are gaps between CP and SFU. CP should be reviewed in accordance to data of evidence-based medicine. Despite the fact that a new edition of SFU was recently published, it does not include antifungal lacquers, which are broadly used and recommended, for example, by British National Formulary. Thus, it is also necessary to analyze antifungal nail lacquers for making decision about including them into SFU.
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