Document Detail


An open randomized comparative study to test the efficacy and safety of oral terbinafine pulse as a monotherapy and in combination with topical ciclopirox olamine 8% or topical amorolfine hydrochloride 5% in the treatment of onychomycosis.
MedLine Citation:
PMID:  18032857     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts and molds. AIMS: To study the efficacy and safety of oral terbinafine pulse as a monotherapy and in combination with topical ciclopirox olamine 8% or topical amorolfine hydrochloride 5% in onychomycosis. METHODS: A clinical comparative study was undertaken on 96 Patients of onychomycosis during the period between August 2005 to July 2006. Forty-eight patients were randomly assigned in group A to receive oral terbinafine 250 mg, one tablet twice daily for seven days every month (pulse therapy); 24 patients in group B to receive oral terbinafine pulse therapy plus topical ciclopirox olamine 8% to be applied once daily at night on all affected nails; and 24 patients in group C to receive oral terbinafine pulse therapy plus topical amorolfine hydrochloride 5% to be applied once weekly at night on all the affected nails. The treatment was continued for four months. The patients were evaluated at four weekly intervals till sixteen weeks and then at 24 and 36 weeks. RESULTS: We observed clinical cure in 71.73, 82.60 and 73.91% patients in groups A, B and C, respectively; Mycological cure rates against dematophytes were 88.9, 88.9 and 85.7 in groups A, B and C, respectively. The yeast mycological cure rates were 66.7, 100 and 50 in groups A, B and C, respectively. In the case of nondermatophytes, the overall response was poor: one out of two cases (50%) responded in group A, while one case each in group B and group C did not respond at all. CONCLUSION: Terbinafine pulse therapy is effective and safe alternative in treatment of onychomycosis due to dermatophytes; and combination therapy with topical ciclopirox or amorolfine do not show any significant difference in efficacy in comparison to monotherapy with oral terbinafine.
Authors:
Amit Jaiswal; R P Sharma; A P Garg
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Indian journal of dermatology, venereology and leprology     Volume:  73     ISSN:  0973-3922     ISO Abbreviation:  Indian J Dermatol Venereol Leprol     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2007-11-22     Completed Date:  2008-02-05     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  7701852     Medline TA:  Indian J Dermatol Venereol Leprol     Country:  India    
Other Details:
Languages:  eng     Pagination:  393-6     Citation Subset:  IM    
Affiliation:
Department of Dermatology and Venereology, L. L. R. M. Medical College, Meerut, Uttar Pradesh, India.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Administration, Topical
Adolescent
Adult
Antifungal Agents / economics,  therapeutic use*
Child
Drug Therapy, Combination
Foot Dermatoses / drug therapy,  microbiology
Hand Dermatoses / drug therapy,  microbiology
Humans
Longitudinal Studies
Middle Aged
Morpholines / economics,  therapeutic use*
Naphthalenes / economics,  therapeutic use*
Onychomycosis / drug therapy*,  microbiology
Pyridones / economics,  therapeutic use*
Single-Blind Method
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Morpholines; 0/Naphthalenes; 0/Pyridones; 29342-05-0/ciclopirox; 67467-83-8/amorolfine; 91161-71-6/terbinafine

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