Combination of oral terbinafine and topical ciclopirox compared to oral terbinafine for the treatment of onychomycosis.
BACKGROUND
Treatment of onychomycosis has recently been enhanced by the introduction of combination therapies.


OBJECTIVE
To evaluate the efficacy of a combination therapy of ciclopirox nail lacquer and oral terbinafine compared to oral terbinafine monotherapy for the treatment of onychomycosis caused by dermatophytes.


METHODS
Eighty patients with onychomycosis were randomly assigned to receive either oral terbinafine 250 mg/day for 16 weeks or a combination of oral terbinafine 250 mg/day for 16 weeks and topical ciclopirox nail lacquer once daily for 9 months. Both groups were followed up for 9 months from start of treatment.


RESULTS
After 9 months of treatment, the mycological cure rates were 22/34 (64.7%) for the terbinafine-only group and 30/34 (88.2%) for the combination therapy group (p<0.05). No significant difference was noted in the complete cure rate.


CONCLUSIONS
Combination therapy of oral terbinafine and ciclopirox nail lacquer is a safe and more effective treatment for onychomycosis than terbinafine alone, especially in younger patients and in shorter-duration onychomycosis.
Avner
Shemer
S
Department of Dermatology, C. Sheba Medical Center, Tel Hashomer, and the Sackler School of Medicine, Tel Aviv University, Israel. felix@post.tau.ac.il
Nir
Nathansohn
N
Henri
Trau
T
D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage*; D000077768:Ciclopirox; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000008:administration & dosage*; D014009:Onychomycosis / Q000188:drug therapy*; D011728:Pyridones / Q000008:administration & dosage*; D000077291:Terbinafine; D016896:Treatment Outcome
D000935:Antifungal Agents; D009281:Naphthalenes; D011728:Pyridones; D000077768:Ciclopirox; D000077291:Terbinafine