A comparative study to evaluate efficacy, safety and cost-effectiveness between Whitfield′s ointment + oral fluconazole versus topical 1% butenafine in tinea infections of skin

Abstract

Aims and Objectives:The aim of this study is to compare the efficacy, safety and cost-effectiveness of topical Whitfield's ointment plus oral fluconazole with topical 1% butenafine in tinea infections of the skin.Materials and Methods:Patients were randomly allocated to the two treatment groups and advised to apply either agent topically twice-a-day for 4 weeks on the lesions and fluconazole (150 mg) was administered once a week for 4 weeks in the study group applying Whitfield's ointment. Patients were followed-up at an interval of 10 days for clinical score and global evaluation response was assessed at baseline and during each follow-up.Results:Out of 120 patients enrolled in the study 103 completed the study. Patients treated with Whitfield's ointment and oral fluconazole reduced mean sign and symptom score from 8.81 ± 0.82 to 0.18 ± 0.59 while butenafine treated patients reduced it from 8.88 ± 0.53 to 0.31 ± 0.67 at the end of the treatment. Nearly, 98% patients were completely cleared of the lesion on the 3rd follow-up with both treatments.Conclusion:Whitfield's ointment with oral fluconazole is as efficacious, safe and cost-effective as compared with 1% butenafine in tinea infections of the skin.

Indian association of dermatologists, venereologists and leprologists (IADVL) task force against recalcitrant tinea (ITART) consensus on the management of glabrous tinea (INTACT)

“…[ 83 84 ] Topical keratolytics, such as Whitfield's ointment (3% salicylic acid with 6% benzoic acid), can be used in the treatment of glabrous tinea, but not on the flexures or face or where the lesions are inflamed. [ 85 86 ]…”

Treatment, prevention and public health management of impetigo, scabies, crusted scabies and fungal skin infections in endemic populations: a systematic review

“…Very low‐quality RCT evidence also found no difference between topical sertaconazole and topical terbinafine and that topical terbinafine and topical luliconazole could not be differentiated . Similarly, low‐quality RCT evidence from India found that daily oral terbinafine or weekly fluconazole achieved similar clinical cures and topical butenafine was no better than weekly fluconazole combined with topical Whitfield's ointment (3% salicylic acid and 6% benzoic acid) at 4 weeks . Low‐quality evidence from a prospective cohort of Australian Aboriginal people with tinea corporis and tinea unguium found daily oral terbinafine cured 32% .…”

A pilot single centre, double blind, placebo controlled, randomized, parallel study of Calmagen® dermaceutical cream and lotion for the topical treatment of tinea and onychomycosis

“…In another study, Global Evaluation Response revealed that skin lesions were completely cleared with Whitfield’s ointment + oral fluconazole and butenafine cream in 98% patients with tinea. However, Whitfield’s ointment caused burning and redness, oral fluconazole caused gastritis, while no adverse events were reported with topical butenafine [ 26 ]. Terbinafine and sertaconazole resulted in complete cure in 100% subjects with Tinea cruris and Tinea corporis at the end of 3 weeks of treatment [ 27 ].…”