title: Tavaborole, Efinaconazole, and Luliconazole: Three New Antimycotic Agents for the Treatment of Dermatophytic Fungi.
abstract: Fungal diseases of the nail bed (onychomycosis) and epidermis are recurrent illnesses in the elderly and immunocompromised patients, which have few efficacious treatment options. Current treatment options for onychomycosis are limited to topical agents, laser treatment, and oral antifungals. Previous generations of topical agents were not efficacious, owing to poor penetration of the nail bed. Oral antifungal drugs, such as itraconazole, terbinafine, and fluconazole, not only give better response rates but also inhibit a host of CYP450 enzymes. Oral antifungals can exacerbate drug-drug interactions for patients taking other medications concurrently. Newer topical agents might recognize improved efficacy and provide therapeutic alternatives when the use of oral antifungal agents is contraindicated. Recently, the Food and Drug Administration (FDA) approved efinaconazole and tavaborole for the treatment of onychomycosis. Additionally, the FDA approved luliconazole for the treatment of tinea pedis, tinea cruris, and tinea corporis. This review examines the mechanism of action, spectrum of activity, pharmacokinetics, and clinical trials data and considers the place in therapy for these 3 new antimycotic agents.
authors.affiliation: 1 College of Pharmacy, Ferris State University, Big Rapids, MI, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Saunders
authors.affiliation: 1 College of Pharmacy, Ferris State University, Big Rapids, MI, USA.
authors.forename: Kayla
authors.initials: K
authors.lastname: Maki
authors.affiliation: 1 College of Pharmacy, Ferris State University, Big Rapids, MI, USA.
authors.forename: Renee
authors.initials: R
authors.lastname: Koski
authors.affiliation: 1 College of Pharmacy, Ferris State University, Big Rapids, MI, USA.
authors.forename: S Eric
authors.initials: SE
authors.lastname: Nybo
mesh_terms: D000287:Administration, Topical; D000818:Animals; D000935:Antifungal Agents / Q000008:administration & dosage*; D003883:Arthrodermataceae / Q000187:drug effects* / Q000502:physiology; D001896:Boron Compounds / Q000008:administration & dosage*; D019086:Bridged Bicyclo Compounds, Heterocyclic / Q000008:administration & dosage*; D003881:Dermatomycoses / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage*; D008826:Microbial Sensitivity Tests / Q000379:methods; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage*
chemical_list: D000935:Antifungal Agents; D001896:Boron Compounds; D019086:Bridged Bicyclo Compounds, Heterocyclic; D007093:Imidazoles; D014230:Triazoles; C431707:efinaconazole; C512998:tavaborole; C112528:luliconazole
keywords: efinaconazole; luliconazole; onychomycosis; tavaborole; topical antifungal