Course Of Terbinafine Research Articles

The First Case of Phaeohyphomycosis Caused by Exophiala xenobiotica in an Immunocompetent Patient in Korea

Phaeohyphomycosis is a rare fungal infection caused by dematiaceous fungi commonly associated with immunocompromised patients. Exophiala (E.) species are linked to phaeohyphomycosis, and in Korea, E. dermatitidis, E. jeanselmei, and E. salmonis were previously isolated from affected patients. Here, we describe a unique instance of phaeohyphomycosis in an immunocompetent patient attributed to E. xenobiotica. A 75-year-old female presented with an asymptomatic erythematous crusted subcutaneous nodule on the dorsum of her left-hand. Her past medical history was negative for immunosuppression or trauma to the affected area. Histopathological examination revealed suppurative granulomatous infiltration, with septate hyphae and spores detected by periodic acid-Schiff staining in the dermis. A fungal culture made from a tissue sample revealed E. xenobiotica, with subsequent confirmation through phylogenetic analyses of the internal transcribed spacer (ITS) and large subunit regions (LSU) of ribosomal ribonucleic acid (rRNA). The patient was diagnosed with phaeohyphomycosis and underwent a 3-week course of terbinafine, followed by 7 weeks of fluconazole. These treatments significantly improved the lesion. To our knowledge, this is the first reported case of phaeohyphomycosis caused by E. xenobiotica in Korea.

Efficacy of daily oral terbinafine versus pulse fluconazole therapy in the treatment of tinea corporis, tinea cruris, and tinea faciei: A comparative study

Introduction: Both terbinafine and fluconazole are effective systemic drugs for dermatophytosis. They can be used intermittently as pulse doses or as daily doses for the treatment of the same. Aim: The aim of this study was to assess the efficacy and safety of 1 week twice a day therapy of terbinafine and to compare it with that of a daily 2-week course of terbinafine and weekly pulse fluconazole therapy. The adverse effects and relapse rates after the completion of therapy were assessed. Materials and Methods: A study was conducted with 90 patients divided into three Groups A, B, and C. Patients were assessed at 2 and 4 weeks of starting treatment and 6 weeks following the completion of treatment. Adverse effects if any were noted. Clinical scores were calculated, and skin scraping for potassium hydroxide (KOH) examination was done. Clinical improvement was assessed. A mycological cure is defined as a negative KOH examination. Results: There was a significant decrease in clinical scores before treatment and at 2 and 4 weeks of visits. The highest clinical cure rates were attained in Group A (80%), followed by Group B (73.33%) and Group C (63.3%). Mycological cure rate at 4 weeks was highest in Group A (93.3%), followed by Group B (86.7%) and Group C (83.3%). This difference in clinical and mycological cure rates in the three groups was not found to be statistically significant. Of the patients who had responded to treatment at 4 weeks, the clinical and mycological cure was maintained in 96.4% individuals in Group A, 96.1% in Group B, and 88% in Group C at 6 weeks. Thus, the highest number of recurrences was seen in Group C, followed by Group B and Group A. All the three treatment regimens were well tolerated. Side effects were seen in 17 patients. They were mild and predominantly gastrointestinal. Conclusion: All three drugs in different regimens were found to be equally efficacious in the treatment of dermatophytic infections in our center.

Utility of Laboratory Test Result Monitoring in Patients Taking Oral Terbinafine or Griseofulvin for Dermatophyte Infections

Terbinafine hydrochloride and griseofulvin are effective oral treatments for dermatophyte infections but have been associated with hepatic and hematologic abnormalities. The prevalence of alanine aminotransferase elevations, aspartate aminotransferase elevations, anemia, lymphopenia, and neutropenia among adults and children taking terbinafine and griseofulvin is unclear. To measure the rate of laboratory test result abnormalities in healthy adults and children taking terbinafine or griseofulvin for dermatophyte infections. This retrospective study assessed adults and children taking terbinafine or griseofulvin for dermatophyte infections from January 1, 2006, to December 31, 2016. Data were collected from one Midwest health care system. Exclusion criteria were preceding diagnosis of hepatic or hematologic condition and preceding or concurrent use of oral ketoconazole, amphotericin, or itraconazole. The rates of elevated alanine aminotransferase measurements, elevated aspartate aminotransferase measurements, anemia, lymphopenia, and neutropenia in adults and children taking terbinafine, griseofulvin microsize, or griseofulvin ultramicrosize were calculated. Secondary measures included rates of baseline abnormalities, frequency of laboratory test results that required additional testing or discontinued use of medication, and laboratory test result monitoring practices. This study included laboratory data from 4985 patients (mean [SD] age, 42.8 [20.3] years; 2288 [45.9%] female) receiving 4309 courses of terbinafine, 634 courses of griseofulvin microsize, and 159 courses of griseofulvin ultramicrosize. We identified a low rate of laboratory test result abnormalities in patients taking terbinafine or griseofulvin. When laboratory test result abnormalities occurred, most were low grade (212 [93.4%] grade 1) and did not require subsequent laboratory test result evaluation or discontinued use of medication (15 051 [99.9%]). Elevations in alanine aminotransferase measurements were detected infrequently and were comparable to baseline detection rates (61 [3.5%] vs 95 [3.6%] for terbinafine, 2 [2.1%] vs 3 [3.7%] for griseofulvin microsize, and 0 vs 2 [5.0%] for griseofulvin ultramicrosize). Rates of elevated aspartate aminotransferase measurements, anemia, lymphopenia, and neutropenia were also infrequent and comparable to baseline rates. In this study. the rates of alanine aminotransferase elevations, aspartate aminotransferase elevations, anemia, lymphopenia, and neutropenia in adults and children taking terbinafine or griseofulvin were low and equivalent to the baseline rates of abnormalities in this population. Routine interval laboratory test result monitoring appears to be unnecessary in adults and children without underlying hepatic or hematologic conditions taking terbinafine or griseofulvin for dermatophyte infections. Abandoning frequent laboratory monitoring can decrease unnecessary health care spending, decrease patient psychological angst associated with blood draws, and allow for expanded use of these effective oral medications.

A Random Comparative Study of Terbinafine Versus Griseofulvin in Patients with Tinea Capitis in Western China

To compare the efficacy and safety of terbinafine with griseofulvin in the treatment of tinea capitis in Western China. Children (2-14 years of age) with clinically diagnosed and potassium hydroxide microscopy-confirmed tinea capitis were randomized into three groups: group GRI4 received 4 weeks of griseofulvin; group TBF2 received 2 weeks of terbinafine; and Group TBF4 received 4 weeks of terbinafine. Clinical and mycological evaluations were done in 0, 2, 4, and 8 weeks and 1 year after therapy started. The isolated pathogenic fungi were evaluated for in vitro susceptibility by detecting the minimal inhibitory concentration (MIC) against terbinafine, griseofulvin, itraconazole, and ketoconazole. The clinical effectiveness rate of GRI4, TBF2, and TBF4 were 100% (95% CI-confidence interval: 82-100%), 96.3% (95% CI: 81-100%), and 100%(95% CI: 85-100%), respectively, at week 8 and 100% after 1 year for the 3 groups; clinical cure rates were 84.2%(95% CI: 77-99%), 85.2%(95% CI: 71-98%), and 78.3%(95% CI: 61-95%), respectively, at week 8 and 100% after 1 year for all agents; mycological cure rates were 100%(95% CI: 74-100%), 95.0%(95% CI: 74-100%), and 94.1%(95% CI: 50-93%) at week 8 and 100% after 1 year for the 3 groups. In vitro, all patient-derived cultures were sensitive to the four antifungal agents. Data from the clinical trial and in vitro antifungal activity indicated that terbinafine is efficacious and well tolerated in the treatment for Trichophyton infections (T. violaceum; Arthroderma vanbreuseghemii; and T. tonsurans) of the scalp, i.e., a 2- to 4-week course of terbinafine is as effective as a 4-week course of griseofulvin; in fact, a 2-week course of terbinafine is sufficient. Terbinafine is an effective alternative to griseofulvin against tinea capitis of Trichophyton infections.

The use of an intermittent terbinafine regimen for the treatment of dermatophyte toenail onychomycosis

To compare the efficacy and safety of intermittent terbinafine with standard courses of terbinafine and itraconazole for dermatophyte toenail onychomycosis. Data from a Canadian study of continuous terbinafine (CTERB) and intermittent itraconazole (III) was compared to an intermittent terbinafine regimen (TOT) using similar protocol to the randomized study. Terbinafine 250 mg/day for 4 weeks followed by 4 weeks of no terbinafine and then an additional 4 weeks of terbinafine 250 mg/day (TOT); terbinafine 250 mg/day for 12 weeks (CTERB); itraconazole pulse of 200 mg twice daily for 7 days on, 21 days off, three pulses given (III). At 72 weeks, mycological cure rates (negative KOH and culture) were 36 of 43 (83.7%), 25 of 32 (78.1%), and 17 of 30 (56.7%), for the TOT, CTERB, and III groups, respectively (P = 0.01 for TOT vs. III). Effective cure rates (simultaneous mycological cure and < or =10% nail plate involvement) were 34 of 43 (79.1%), 21 of 32 (65.6%), and 11 of 30 (36.7%), respectively (P < 0.001 for TOT vs. III; P = 0.02 for CTERB vs. III). No significant differences in effective and mycological cure rates were noted between the two terbinafine groups. Adverse events reported were similar to those reported in the respective package inserts. Most adverse events were mild to moderate, transient, and did not require interruption of the drug regimens. No serious adverse events were reported. A TOT intermittent terbinafine regimen provided similar efficacy and safety to the gold standard continuous terbinafine regimen and better effective cure rates than pulse itraconazole therapy.

Severe osteomyelitis caused by Myceliophthora thermophila after a pitchfork injury

BackgroundTraumatic injuries occurring in agricultural settings are often associated with infections caused by unusual organisms. Such agents may be difficult to isolate, identify, and treat effectively.Case reportA 4-year-old boy developed an extensive infection of his knee and distal femur following a barnyard pitchfork injury. Ultimately the primary infecting agent was determined to be Myceliophthora thermophila, a thermophilic melanized hyphomycete, rarely associated with human infection, found in animal excreta. Because of resistance to standard antifungal agents including amphotericin B and caspofungin, therapy was instituted with a prolonged course of terbinafine and voriconazole. Voriconazole blood levels demonstrated that the patient required a drug dosage (13.4 mg/kg) several fold greater than that recommended for adults in order to attain therapeutic blood levels.ConclusionUnusual pathogens should be sought following traumatic farm injuries. Pharmacokinetic studies may be of critical importance when utilizing antifungal therapy with agents for which little information exists regarding drug metabolism in children.

Griseofulvin Versus Terbinafine in the Treatment of Tinea Capitis: A Meta-analysis of Randomized, Clinical Trials

Tinea capitis, a common pediatric infection in the United States, is caused mainly by Trichophyton species and affects many urban children. Although the current treatment of choice is oral griseofulvin, terbinafine has been shown to be variably effective in several comparative, randomized trials. The purpose of this study was to perform a meta-analysis of randomized, clinical trials comparing the efficacies of oral terbinafine and oral griseofulvin for the treatment of childhood tinea capitis. The Medline database was searched for randomized, clinical studies comparing griseofulvin and terbinafine for the treatment of tinea capitis. Acceptance criteria included oral administration of griseofulvin for at least 6 weeks and the identification of a pathogenic dermatophyte from the scalp at the time of enrollment in the study. Scalp culture status at least 8 weeks after enrollment was used as the outcome. The common odds ratio (OR) with 95% confidence intervals (CIs), the Cochran-Mantel-Haenszel test for significance, and the Breslow-Day test for homogeneity were calculated. Six articles that satisfied all inclusion criteria were identified. These studies were combined by using outcomes at 12 to 16 weeks after enrollment. The common OR was 0.86 (95% CI: 0.57-1.27). When the 5 studies that identified Trichophyton species as the predominant pathogen were combined, using outcomes 12 weeks after enrollment, the results nearly favored terbinafine (OR: 0.65 [95% CI: 0.42-1.01]). For outcomes at 8 weeks after enrollment, no difference was found between the agents (OR: 0.84 [95% CI: 0.54-1.32]). Consclusions.A 2- to 4-week course of terbinafine is at least as effective as a 6- to 8-week course of griseofulvin for the treatment of Trichophyton infections of the scalp. Griseofulvin is likely to be superior to terbinafine for the rare cases caused by Microsporum species.

Seven days of intermittent terbinafine 250 mg treatment in Tinea pedis

Tinea pedis responds well to topical antifungal therapy, however, relapse of the disease is not uncommon. Long-term application of antifungals is usually necessary to control relapse. We conducted an open trial of a 7 day intermittent course of oral terbinafine treatment at 250 mg/day for plantar type and interdigital type of tinea pedis. Seventy-five patients of plantar type and 49 patients of interdigital tinea pedis were treated with a 7 day course of terbinafine 250 mg/day. Clinical assessments were made at baseline and every 4 weeks. Another 7 day course of the same amount of terbinafine were given depending on the clinical and the mycological response. Of the 75 plantar type tinea pedis with 8 patients excluded, 66 of the remaining 67 (98.5%) were evaluated as cured. Of the 49 interdigital tinea pedis (3 excluded), 43 of 46 patients (93.5%) cured. Relapse of the disease was observed in 4 of 51 patients at 1 year after treatment, 4 of 25 at 2 years, and 2 of 9 at 3 years in the plantar type, and in 4 of 30 at 1 year, 0 of 14 at 2 years, and 0 of 6 at 3 years in the interdigital tinea pedis group. Intermittent terbinafine therapy is thus effective in the treatment of tinea pedis.

Once daily treatment with terbinafine 1% cream (Lamisil®) for one week is effective in the treatment of tinea corporis and cruris. A placebo‐controlled study

Summary. Duration of therapy is an important factor in determining patients' compliance in dermatomycosis. Terbinafine (Lamisil®) is an allylamine antifungal agent. Its fungicidal properties against dermatophytes should allow physicians to reduce treatment duration without affecting the cure rate. This study was carried out to determine the efficacy and tolerability of terbinafine 1% cream, applied once daily for 7 days, in adult patients with tinea corporis/cruris.In a multicentre, randomized, double‐blind, parallel‐group study, patients with a clinical diagnosis of tinea corporis/cruris confirmed by microscopy and culture received treatment with either terbinafine 1% cream (n = 57) or placebo cream (n = 60). The patients applied the cream once daily for 7 days, and were then observed for a further 7 weeks. The efficacy was assessed at the end of the study by comparing the rates of mycological cure in the two treatment groups. Total clinical signs and symptoms scores, clinical response, and overall treatment efficacy were also measured and compared between the two groups.A 7‐day once‐daily course of terbinafine was significantly more effective than placebo in achieving and maintaining mycological cure (84.2 versus 23.3%, P &lt; 0.001). Terbinafine was also significantly more effective than placebo in terms of clinical response, reduction in signs and symptoms scores, and overall efficacy. The short treatment regimen and the sustained high cure rate should contribute to making terbinafine a valuable treatment option in tinea corporis/cruris.

Once daily treatment with terbinafine 1% cream (LamisilR) for one week is effective in the treatment of tinea corporis and cruris. A placebo-controlled study

Duration of therapy is an important factor in determining patients' compliance in dermatomycosis. Terbinafine (Lamisil) is an allylamine antifungal agent. Its fungicidal properties against dermatophytes should allow physicians to reduce treatment duration without affecting the cure rate. This study was carried out to determine the efficacy and tolerability of terbinafine 1% cream, applied once daily for 7 days, in adult patients with tinea corporis/cruris. In a multicentre, randomized, double-blind, parallel-group study, patients with a clinical diagnosis of tinea corporis/cruris confirmed by microscopy and culture received treatment with either terbinafine 1% cream (n = 57) or placebo cream (n = 60). The patients applied the cream once daily for 7 days, and were then observed for a further 7 weeks. The efficacy was assessed at the end of the study by comparing the rates of mycological cure in the two treatment groups. Total clinical signs and symptoms scores, clinical response, and overall treatment efficacy were also measured and compared between the two groups. A 7-day once-daily course of terbinafine was significantly more effective than placebo in achieving and maintaining mycological cure (84.2 versus 23.3%, P< 0.001). Terbinafine was also significantly more effective than placebo in terms of clinical response, reduction in signs and symptoms scores, and overall efficacy. The short treatment regimen and the sustained high cure rate should contribute to making terbinafine a valuable treatment option in tinea corporis/cruris.

Reversible agranulocytosis associated with oral terbinafine in a pediatric patient

We report a case of terbinafine-induced agranulocytosis in a pediatric patient. This effect was noted 4 weeks after starting terbinafine and resolved within 1 week without the institution of therapy with granulocyte colony-stimulating factor, a course similar to reports in adults. With the incidence of severe side effects still unclear in children, this case argues for continued blood surveillance during courses of terbinafine and for the confirmation of infection before initiation of the drug. (J Am Acad Dermatol 2001;45:632-4.)

How often does oral treatment of toenail onychomycosis produce a disease-free nail? An analysis of published data.

To analyze studies on oral treatment of toenail onychomycosis so as to aid clinicians and patients in making informed decisions. Studies dealing with treatment of toenail onychomycosis were identified by means of 2 MEDLINE search strategies. One was a title search using the word "toenail"; the other search used the combined Medical Subject Headings "onychomycosis" and "therapy". Articles were read to ascertain that they (1) described results in toenails, (2) used both culture and microscopy, and (3) included a clinical evaluation. Not included were case reports, series of fewer than 15 subjects, reports that combined fingernail onychomycosis and toenail onychomycosis in their statistics, and articles reporting only the total number of toenails cured without providing data as to how many subjects were cured. This elimination process left 26 articles, which were then analyzed by means of a checklist that included a morphologically normal nail, mycological findings, and methodological items including recurrence rate, intent-to-treat analysis, placebo group, and whether terms were defined. When there was sufficient data, the frequency with which the treatment achieved normal mycological results, a clinically normal nail, and a disease-free nail (normal-appearing nail plus normal mycological results) was calculated. Confidence intervals were calculated for disease-free nail results. Standard courses of terbinafine achieved a disease-free nail in approximately 35% to 50% of patients. For itraconazole, the relevant disease-free nail rate was about 25% to 40%. Disease reappearance is an important issue; unfortunately data are lacking as to its frequency.

Non-dermatophytes in onychomycosis of the toenails

A multicentre trial for the treatment of dermatophyte onychomycosis of the toenails with terbinafine was carried out in Australia and New Zealand. Between eight and 12 nail samples were obtained from each of the 118 patients in the 48-week trial, and each sample was investigated by direct microscopy and culture for dermatophyte and non-dermatophyte fungi. Patients were randomized to treatment with terbinafine at 250 mg/day or placebo for the first 12 weeks of the study, then non-responders were offered a 12-week course of terbinafine from week 28. All patients had a dermatophyte infection. In 42 patients (36%) microscopy and mycological culture identified dermatophytes alone. In the remaining 76 patients (64%), a non-dermatophyte mould or yeast was also isolated at some stage during the trial, but in only three patients did the same non-dermatophyte persist in two or more successive nail specimens. The presence of a fungal contaminant in addition to a dermatophyte had no apparent effect on the efficacy of treatment with terbinafine. We conclude that non-dermatophyte moulds and yeasts are generally found as contaminating organisms in dermatophyte onychomycosis, secondary to the dermatophytes, and that they do not influence the outcome of treatment.

Non-dermatophytes in onychomycosis of the toenails

A multicentre trial for the treatment of dermatophyte onychomycosis of the toenails with terbinafine was carried out in Australia and New Zealand. Between eight and 12 nail samples were obtained from each of the 118 patients in the 48-week trial, and each sample was investigated by direct microscopy and culture for dermatophyte and non-dermatophyte fungi. Patients were randomized to treatment with terbinafine at 250 mg/day or placebo for the first 12 weeks of the study, then non-responders were offered a 12-week course of terbinafine from week 28. All patients had a dermatophyte infection. In 42 patients (36%) microscopy and mycological culture identified dermatophytes alone. In the remaining 76 patients (64%), a non-dermatophyte mould or yeast was also isolated at some stage during the trial, but in only three patients did the same non-dermatophyte persist in two or more successive nail specimens. The presence of a fungal contaminant in addition to a dermatophyte had no apparent effect on the efficacy of treatment with terbinafine. We conclude that non-dermatophyte moulds and yeasts are generally found as contaminating organisms in dermatophyte onychomycosis, secondary to the dermatophytes, and that they do not influence the outcome of treatment.

Onychomycosis--treatment, relapse and re-infection.

The treatment of onychomycosis has improved considerably following the introduction of the oral antifungals terbinafine and itraconazole. The pharmacokinetic characteristics of both these drugs has made short treatment times effective. Patients with a culture-proven dermatophyte infection of the toe-nails, receiving terbinafine 250 mg daily for 12 weeks, have a 70% chance of cure. The risk of relapse is probably less than 10%, and this may be prevented by a further course of terbinafine should the expected increasing length of unaffected nail growth stall or cultures become positive. Once cured, the regular and prophylactic use of an effective topical antifungal may help to prevent a recurrence of tinea pedis and onychomycosis.

Terbinafine in onychomycosis of the toenail: A novel treatment protocol

Background: Current treatment of onychomycosis of the toenail is poor and relapse is common. Objective: Our purpose was to assess the efficacy and safety of oral terbinafine and placebo in onychomycosis of the toenail with the use of a novel treatment protocol. Methods: This was a randomized, double-blin, 48-week study. Twelve weeks of terbinafine (250 mg daily) or placebo was followed by 12 weeks of observation. Responders received no further treatment and nonresponders were offered 12 weeks of terbinafine (250 mg daily) from week 28. Results: Of 111 evaluable patients, 88% (49 of 56) of the patients given terbinafine and 29% (16 of 55) of the patients given placebo had a negative mycologic culture at week 24 ( p < 0.001), 57% (32 of 56) of the terbinafine group and 6% (3 of 55) of the placebo group were responders ( p < 0.001). By week 48, after the terbinafine nonresponders were given a second 12-week course of terbinafine, the overall mycologic cure rate for the patients given terbinafine was 94%. Conclusion: High mycologic cure rates in onychomycosis of the toenail can be achieved by terbinafine by this novel treatment regimen.

Effect of Terbinafine on the Pharmacokinetics of Cyclosporin in Humans

Cyclosporin is largely metabolized by hepatic cytochrome P450 enzymes, and azole drugs that inhibit cytochrome P450 may precipitate cyclosporin toxicity. The allylamine terbinafine binds to a small subfraction of hepatic cytochrome P450 in type I fashion, and has no effect upon hepatic metabolism of cyclosporin in vitro. The purpose of this study was to determine whether oral terbinafine alters the pharmacokinetics of oral cyclosporin in vivo. Twenty male volunteers (age 19-44 years), were randomly allocated to two groups. The first group received three single oral doses of cyclosporin 300 mg at intervals of 21 d. The second and third doses of cyclosporin were preceded by a 6-d course of oral terbinafine 250 mg each morning. A further 250 mg of terbinafine was taken with the second and third doses of cyclosporin. Blood levels of cyclosporin and terbinafine were monitored for 36 h after each dose. The second group received a 7-d course of terbinafine 250 mg each morning. On the seventh day a single dose of cyclosporin 300 mg was taken together with the terbinafine. Blood levels of both cyclosporin and terbinafine were monitored for 36 h. Two further single doses of cyclosporin 300 mg were given at intervals of 2 weeks and the cyclosporin levels again monitored. In both groups each cyclosporin dose was preceded by an 8-h fast. The mean peak blood concentration of cyclosporin when taken alone was 958 micrograms/l, and 822 when taken with terbinafine. The mean area under the curve for cyclosporin was 4207 micrograms/l/h when taken alone and 3665 when taken with terbinafine. The mean absorption half-life for cyclosporin when taken alone was 0.29 h, and 0.33 when taken with terbinafine. The mean time of maximum concentration and elimination half-life of cyclosporin were unaltered by terbinafine. The results suggest that terbinafine is likely to prove a safe systemic anti-fungal treatment for patients who are taking cyclosporin.

Comparison of terbinafine and clotrimazole in treating tinea pedis.

To compare the efficacy and safety of terbinafine 1% cream and clotrimazole 1% cream in the treatment of tinea pedis. Multicentre, double blind parallel group study. 32 general practices and one hospital. 256 patients with mycologically confirmed tinea pedis. Of the 211 patients evaluable, 107 were randomised to terbinafine (75 male, 32 female; mean (range) age 40 (12-81) years) and 104 to clotrimazole (79 male, 25 female; mean (range) age 36 (12-71) years). Terbinafine 1% cream applied twice daily for one week and inert cream applied twice daily for the next three weeks. Clotrimazole 1% cream applied twice daily for four weeks. Mycological cure (negative results on microscopy and culture) and effective treatment (mycological cure plus no or minimal signs and symptoms) measured at weeks 1, 2, 3, 4, and 6. At week four rates of mycological cure were 93.5% for terbinafine and 73.1% for clotrimazole (p = 0.0001); and at week six 97.2% for terbinafine and 83.7% for clotrimazole (p = 0.001). Rates of effective treatment at week 4 were 89.7% for terbinafine and 58.7% for clotrimazole (p = 0.0001); and 89.7% for terbinafine and 73.1% for clotrimazole (p = 0.002) at week 6. These results indicate that a one week course of terbinafine 1% cream is more effective in the treatment of tinea pedis than a four week course of clotrimazole 1% cream, both in terms of mycological cure and effective treatment.

Shorter courses of terbinafine proposed for fungal nail infections

Shorter courses of terbinafine proposed for fungal nail infections