title: Intermittent therapy with terbinafine and nail abrasion for dermatophyte toe onychomycosis: a pilot study.
abstract: Onychomycosis constitutes up to 50% of all nail disorders. Toenails are generally affected, mostly due to dermatophytes. Terbinafine is the most potent antifungal agent in vitro against dermatophytes. There are few randomised controlled trials using a non-continuous dose of terbinafine. The aim of this open-label pilot study was to reduce the total drug amount, the collateral effects and, specially, the costs; albeit maintaining the same efficacy of the standard regimens. Compare the outcomes of two different intermittent regimens with the same total amount of the medication (42 tablets in 6 months). Forty-one patients were divided into the following groups: terbinafine 250 mg day(-1) , for 7 days, monthly or terbinafine 500 mg day(-1) , once daily, for 7 days, every 2 months, both plus nail abrasion during 6 months. The efficacy was evaluated at months 6, 12 and 18 using the disease free nail criteria. Total cure = group I: eight patients (44.4%) and group II: eight patients (44.4%). Partial cure = group I: five patients (27.8%) and group II: four patients (22.2%). Treatment failure = group I: five patients (27.8%) and group II: three patients (16.7%). Recurrence = group I: zero patients (0.0%) and group II: three patients (16.7%). Two intermittent dosing regimens of terbinafine plus nail abrasion proved to be an alternative statistically effective, safe and with reduced drug costs for dermatophytes toenail onychomycosis.
authors.affiliation: Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. ibsucci@gmail.com
authors.forename: Isabella B
authors.initials: IB
authors.lastname: Succi
authors.forename: Andréa R
authors.initials: AR
authors.lastname: Bernardes-Engemann
authors.forename: Rosane
authors.initials: R
authors.lastname: Orofino-Costa
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003883:Arthrodermataceae / Q000302:isolation & purification; D004341:Drug Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000382:microbiology* / Q000473:pathology; D009281:Naphthalenes / Q000008:administration & dosage* / Q000627:therapeutic use; D014009:Onychomycosis / Q000188:drug therapy* / Q000473:pathology; D010865:Pilot Projects; D012008:Recurrence; D012720:Severity of Illness Index; D000077291:Terbinafine; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D009281:Naphthalenes; D000077291:Terbinafine