Treatment of Candida nail infection with terbinafine.
BACKGROUND
Terbinafine is a highly potent drug against dermatophytes. Data regarding its effectiveness against Candida species are few and variable.


OBJECTIVE
Our purpose was to evaluate the efficacy and safety of oral terbinafine in patients with Candida nail infection.


METHODS
In an open-label uncontrolled study, 20 patients completed 16 weeks of treatment with terbinafine, 250 mg/day, and an additional 8 weeks with placebo. Efficacy was assessed clinically and mycologically at weeks 0 (baseline), 4, 8, 16, 24, 36, and 48. Routine laboratory studies were performed at baseline and weeks 4, 8, and 16.


RESULTS
At the end of the trial 60% of target nails were cured clinically and mycologically; in 10% there was mycologic cure with residual clinical signs, in 25% a moderate improvement (> 50%), and failure in only 5% (one patient). Most nails were infected by Candida parapsilosis. Two of 28 patients showed mild reversible elevation of liver enzymes 1 month after initiation of terbinafine treatment.


CONCLUSIONS
The administration of terbinafine for 16 weeks is effective in the treatment of Candida nail infection. Liver enzyme values should be determined during the first month of treatment.
Segal
R
R
Department of Dermatology, Beilinson Medical Centre, Petah Tikva, Israel.
Kritzman
A
A
Cividalli
L
L
Samra
Z
Z
David
M
M
Tiqva
P
P
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002177:Candidiasis / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000382:microbiology; D009281:Naphthalenes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014009:Onychomycosis / Q000188:drug therapy* / Q000382:microbiology; D000077291:Terbinafine
D000935:Antifungal Agents; D009281:Naphthalenes; D000077291:Terbinafine