Efficacy of topical antifungal drugs in different dermatomycoses: a systematic review with meta-analysis.
OBJECTIVE
To evaluate and compare the efficacy of topical antifungal drugs applied to the treatment of each dermatomycosis.


METHODS
A systematic review of randomized clinical trials, published in Portuguese, Spanish and English until July 2010, which compared the use of azole and allylamine antifungal drugs among themselves and with placebo in the treatment of cutaneous candidiasis and T. versicolor, T. pedis, T. cruris and T. corporis was performed. The efficacy outcomes evaluated were mycological cure at the end of treatment and sustained cure.


RESULTS
Of the 4,424 studies initially identified, 49 met the selection criteria and were included in the meta-analyses. The grouped efficacy data evidenced the superiority of antifungal drugs compared to placebo, regardless of the dermatomycosis under evaluation, with odds ratio values ranging from 2.05 (95% CI 1.18-3.54) to 67.53 (95% CI 11.43-398.86). Allylamines were better than azoles only for the outcome sustained cure (OR 0.52 [95% CI 0.31-0.89]).


CONCLUSIONS
There is consistent evidence of the superiority of antifungal drugs over the use of placebo, and placebo-controlled studies are no longer justifiable. Allylamines maintain the mycological cure for longer periods compared to azole drugs. Given the significant cost difference among the classes, pharmacoeconomic analyses should be performed.
Programa de Ciências Farmacêuticas, Universidade Federal do Paraná, Curitiba, PR, Brazil. 　inarotta@gmail.com
Inajara
I
Rotta
Michel Fleith
MF
Otuki
Andréia Cristina Conegero
AC
Sanches
Cassyano Januário
CJ
Correr
D000279:Administration, Cutaneous; D000935:Antifungal Agents / Q000008:administration & dosage*; D002179:Candidiasis, Cutaneous / Q000188:drug therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D014005:Tinea / Q000188:drug therapy*; D016896:Treatment Outcome
D000935:Antifungal Agents