Itraconazole therapy is effective for pedal onychomycosis caused by some nondermatophyte molds and in mixed infection with dermatophytes and molds: a multicenter study with 36 patients.
BACKGROUND
Onychomycosis of the toenail caused by nondermatophyte molds alone or in combination with dermatophytes is difficult to eradicate with standard antifungal therapy.


OBJECTIVE
Our purpose was to determine the effectiveness of itraconazole in the treatment of toenail onychomycosis caused by molds alone or in combination with dermatophytes.


METHODS
We treated 36 patients with this drug given as continuous dosing (100 or 200 mg/ day) for 6 to 20 weeks or as a 1-week pulse dosing (200 mg twice daily for 1 week per month) for two to four pulses.


RESULTS
Patients with toenail onychomycosis with the following organisms were treated: Aspergillus spp. (eight patients), Fusarium spp. (four patients), Scopulariopsis brevicaulis (23 patients), and Alternaria spp. (one patient). Nineteen patients had onychomycosis with a mixed origin. At follow-up, 12 months after therapy was initiated, clinical and mycologic cure was achieved in 15 of 17 patients (88%) with onychomycosis caused by a single mold. In patients with mixed infection, a clinical cure was obtained in 16 of 19 patients (84%) and a mycologic cure in 13 of 19 patients (68%).


CONCLUSIONS
Itraconazole appears to be effective and safe for the treatment of toenail onychomycosis caused by some nondermatophyte molds alone or in combination with dermatophytes.
De Doncker
P R
PR
Clinical Research Department, Janssen Research Foundation, Beerse, Belgium.
Scher
R K
RK
Baran
R L
RL
Decroix
J
J
Degreef
H J
HJ
Roseeuw
D I
DI
Havu
V
V
Rosen
T
T
Gupta
A K
AK
Piérard
G E
GE
D000935:Antifungal Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D005533:Foot Dermatoses / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use*; D014009:Onychomycosis / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome
D000935:Antifungal Agents; D017964:Itraconazole