The new oral antifungal agents for onychomycosis of the toenails.
OBJECTIVE
To review the use of the new oral antifungal agents, itraconazole, terbinafine and fluconazole for the treatment of onychomycosis of the toenails.


BACKGROUND
Until about 10 years ago the two oral agents available to treat onychomycosis were griseofulvin and ketoconazole. Since then the new oral antifungal agents have superseded the traditional oral agents for the management of toenail onychomycosis.


METHODS
Literature review.


CONCLUSIONS
Itraconazole, terbinafine and fluconazole have been used approximately 100 million times to treat superficial mycoses. These agents are more effective than the traditional antimycotics for the treatment of pedal onychomycosis; furthermore, the new agents have a broader spectrum of action than griseofulvin. In general, itraconazole, terbinafine and fluconazole have a favorable adverse-effects profile with drug interactions that are usually predictable and manageable. The new oral antifungal agents have a high benefit-to-risk ratio when used to treat toenail onychomycosis.
Gupta
A K
AK
Department of Medicine, Sunnybrook Health Science Center and the University of Toronto, Canada. agupta@execulink.com
Shear
N H
NH
D000284:Administration, Oral; D000935:Antifungal Agents / Q000008:administration & dosage*; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage; D005533:Foot Dermatoses / Q000175:diagnosis / Q000188:drug therapy; D006118:Griseofulvin / Q000008:administration & dosage; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage; D008297:Male; D009281:Naphthalenes / Q000008:administration & dosage; D014009:Onychomycosis / Q000175:diagnosis / Q000188:drug therapy*; D000077291:Terbinafine; D016896:Treatment Outcome
D000935:Antifungal Agents; D009281:Naphthalenes; D017964:Itraconazole; D006118:Griseofulvin; D015725:Fluconazole; D000077291:Terbinafine