An open randomized comparative study of oral itraconazole pulse and terbinafine pulse in the treatment of onychomycosis

Abstract

Both oral itraconazole and terbinafine are effective in the treatment of onychomycosis when administered in the pulse dosage form. Terbinafine is more cost effective while itraconazole has a broader spectrum of antimycotic activity.

Update on terbinafine with a focus on dermatophytoses

“…In the treatment of distal and lateral subungual onychomycosis restricted to dermatophytes, no appreciable difference was observed between itraconazole (400 mg/day one week "on" three weeks "off ") and terbinafi ne (mycological cure rates: 75%-90% vs 76%-87%, clinical cure rates 53%-82% vs 50%-79%). [135][136][137][138] Not surprisingly, itraconazole demonstrated superior cure rates among the non-dermatophyte moulds (62% vs 44%) and Candida species (92% vs 40%). 138 These studies are contradicted by a large multi-national trial wherein mycological cure rates at 18 months were significantly greater with terbinafine (76%-80%) than observed with pulse-dose itraconazole (38%-49%).…”

“…[135][136][137][138] Not surprisingly, itraconazole demonstrated superior cure rates among the non-dermatophyte moulds (62% vs 44%) and Candida species (92% vs 40%). 138 These studies are contradicted by a large multi-national trial wherein mycological cure rates at 18 months were significantly greater with terbinafine (76%-80%) than observed with pulse-dose itraconazole (38%-49%). 139 In selected subpopulations, complete cure rates observed after 4 years remained superior in the terbinafi ne arm (24%-78%) compared with those receiving itraconazole (24%-28%) as did mycological cure (46% vs 13%).…”

Efficacy and safety of 1064-nm Nd:YAG laser in treatment of onychomycosis

“…Mishra et al (26) conducted a study of oral itraconazole and terbinafine pulse therapy for onychomycosis. They found an approximately 50% cure rate from both drugs 4 months after complete treatment, although fungal cultures in all patients were still positive 3 months after complete treatment.…”

Treatment of dermatophyte toenail onychomycosis with itraconazole

“…11 Mishra et al noted clinical cure rate of 82% and mycological cure rate of 90% with itraconazole pulse therapy in dermatophyte caused toenail onychomycosis. 12 Gupta et al attained mycological cure by 88.2% and clinical cure by 52.9% in patients of toenail onychomycosis caused by dermatophytes treated with itraconazole pulse therapy. 13 They also observed itraconazole pulse therapy effective and safe in people with diabetes.…”