title: Treatment of dermatophyte onychomycosis with three pulses of terbinafine (500 mg day for a week).
abstract: We assessed the safety and efficacy of pulse therapy with terbinafine tablets in 55 patients with dermatophytic onychomycosis. One pulse consisted of oral terbinafine tablets (500 mg day(-1)) given for 1 week usually followed by a 3-week interval. This regimen was repeated twice. Topical 1% terbinafine cream was applied daily. Efficacy was assessed based on both clinical and mycological examinations 1 year after treatment initiation. We observed a complete cure in 41 patients (74.5%), marked improved in three patients (5.6%), slight improvement in three patients (5.6%) and drop out in six patients (10.7%). Two patients (3.6%) discontinued terbinafine because of gastrointestinal disturbance (one patient) and drug-induced eruption (one patient). No patient had abnormal laboratory findings, including liver function tests. In summary, a regimen of three pulses of terbinafine therapy given daily for 1 week in combination with topical application of terbinafine cream appears to be safe and effective in treating dermatophytic onychomycosis and offers advantages in convenience and cost-effectiveness compared with continuous dosing.
authors.affiliation: Department of Dermatology and Allergology, Juntendo University Nerima Hospital, Nerima-ku, Tokyo, Japan. h007uc@yamaguchi-u.ac.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Takahata
authors.forename: M
authors.initials: M
authors.lastname: Hiruma
authors.forename: Y
authors.initials: Y
authors.lastname: Shiraki
authors.forename: Y
authors.initials: Y
authors.lastname: Tokuhisa
authors.forename: T
authors.initials: T
authors.lastname: Sugita
authors.forename: M
authors.initials: M
authors.lastname: Muto
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D003883:Arthrodermataceae / Q000187:drug effects; D005260:Female; D006801:Humans; D008099:Liver / Q000187:drug effects; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000008:administration & dosage* / Q000009:adverse effects*; D014009:Onychomycosis / Q000188:drug therapy*; D000077291:Terbinafine; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D009281:Naphthalenes; D000077291:Terbinafine