Efficacy of oral terbinafine versus itraconazole in treatment of dermatophytic infection of skin – A prospective, randomized comparative study

Bhatia, Anuradha; Kanish, Bimal; Badyal, Dinesh; Kate, Prajakta; Choudhary, Swati

doi:10.4103/ijp.ijp_578_17

Cited by 55 publications

(49 citation statements)

References 15 publications

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“…To determine if SL-YS3 affects the cell membrane of T. mentagrophytes, microscopic evaluation of SL-YS3 treated mycelia was performed. TRB was included as the standard drug for this study as it is the first line of drug for the treatment of tinea corporis and tinea cruris due to its favorable mycological and pharmacokinetic profile (Bhatia et al, 2019). TRB acts by inhibiting the enzyme squalene epoxidase, thereby inhibiting ergosterol synthesis.…”

Section: Discussionmentioning

confidence: 99%

Sophorolipid Biosurfactant Can Control Cutaneous Dermatophytosis Caused by Trichophyton mentagrophytes

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Sophorolipid Biosurfactant Can Control Cutaneous Dermatophytosis Caused by Trichophyton mentagrophytes

et al. 2020

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“… 24 , 52 , 84 Randomized control trials support the efficacy of systemic treatment with oral antifungal agents. 116 , 117 Oral antifungal agents used for the treatment of tinea corporis include itraconazole (children: 3–5 mg/kg/day [maximum 200 mg/day]; adults: 200 mg/day), fluconazole (children: 6 mg/kg once weekly [maximum: 200 mg once weekly]; adults: 200 mg once weekly), terbinafine granules (children: <25 kg, 125 mg/day; 25–35 kg, 187.5 mg/day; >35 kg, 250 mg/day), and terbinafine tablets (children: 10–20 kg, 62.5 mg/day; 21–40 kg, 125 mg/day; >40 mg, 250 mg/day; adults: 250 mg/day). 2 , 24 , 56 , 118 The duration of treatment varies, depending on the response.…”

Section: Treatmentmentioning

confidence: 99%

“…In recent years, the incidence of tinea corporis refractory to terbinafine treatment has been on the rise. 116 , 120 – 124 Terbinafine acts by inhibiting the enzyme squalene epoxidase, which is responsible for synthesis of ergosterol – an essential component of fungal cell wall. 122 Resistance to terbinafine has largely been attributed to point mutations in the squalene epoxidase target gene ( SQLE ).…”

Section: Treatmentmentioning

confidence: 99%

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Tinea corporis: an updated review

Leung¹,

Lam²,

Leong³

et al. 2020

DIC

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Background Tinea corporis is a common fungal infection that mimics many other annular lesions. Physicians must familiarize themselves with this condition and its treatment. Objective This article aimed to provide a narrative updated review on the evaluation, diagnosis, and treatment of tinea corporis. Methods A PubMed search was performed with Clinical Queries using the key term ‘tinea corporis.’ The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies, and reviews. The search was restricted to the English language. The information retrieved from the mentioned search was used in the compilation of the present article. Results Tinea corporis typically presents as a well-demarcated, sharply circumscribed, oval or circular, mildly erythematous, scaly patch or plaque with a raised leading edge. Mild pruritus is common. The diagnosis is often clinical but can be difficult with prior use of medications, such as calcineurin inhibitors or corticosteroids. Dermoscopy is a useful and non-invasive diagnostic tool. If necessary, the diagnosis can be confirmed by microscopic examination of potassium hydroxide wet-mount preparations of skin scrapings from the active border of the lesion. Fungal culture is the gold standard to diagnose dermatophytosis especially if the diagnosis is in doubt and results of other tests are inconclusive or the infection is widespread, severe, or resistant to treatment. The standard treatment of tinea corporis is with topical antifungals. Systemic antifungal treatment is indicated if the lesion is multiple, extensive, deep, recurrent, chronic, or unresponsive to topical antifungal treatment, or if the patient is immunodeficient. Conclusion The diagnosis of tinea corporis is usually clinical and should pose no problem to the physician provided the lesion is typical. However, many clinical variants of tinea corporis exist, rendering the diagnosis difficult especially with prior use of medications, such as calcineurin inhibitors or corticosteroids. As such, physicians must be familiar with this condition so that an accurate diagnosis can be made and appropriate treatment initiated.

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“…Most superficial infections caused by dermatophytes are successfully treated with terbinafine [1,12]. This antimycotic belongs to the allylamine group and is recommended as the first-line oral medication for the treatment of such infections [13][14][15]. The drug disturbs the formation of ergosterol, i.e., the major sterol of the fungal membrane, by blocking the squalene epoxidase enzyme and subsequently inhibiting the fungal growth [16,17].…”

Section: Introductionmentioning

confidence: 99%

Intrinsic resistance to terbinafine among human and animal isolates of Trichophyton mentagrophytes related to amino acid substitution in the squalene epoxidase

et al. 2020

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Background Dermatomycoses are the most common fungal infections in the world affecting a significant part of the human and animal population. The majority of zoophilic infections in humans are caused by Trichophyton mentagrophytes. Currently, the first-line drug for both oral and topical therapy is terbinafine. However, an increasing number of cases that are difficult to be cured with this drug have been noted in Europe and Asia. Resistance to terbinafine and other allylamines is very rare and usually correlated with point mutations in the squalene epoxidase gene resulting in single amino acid substitutions in the enzyme, which is crucial in the ergosterol synthesis pathway. Purpose Here, we report terbinafine-resistant T. mentagrophytes isolates among which one was an etiological factor of tinea capitis in a man and three were obtained from asymptomatic foxes in Poland. Methods We used the CLSI protocol to determine antifungal susceptibility profiles of naftifine, amphotericin B, griseofulvin, ketoconazole, miconazole, itraconazole, voriconazole, and ciclopirox. Moreover, the squalene epoxidase gene of the terbinafine-resistant strains was sequenced and analysed. Results In the genomes of all four resistant strains exhibiting elevated MICs to terbinafine (16 to 32 µg/ml), single-point mutations leading to Leu393Phe substitution in the squalene epoxidase enzyme were revealed. Among the other tested substances, a MIC50 value of 1 µg/ml was shown only for griseofulvin. Conclusion Finally, our study revealed that the terbinafine resistance phenomenon might not be acquired by exposure to the drug but can be intrinsic. This is evidenced by the description of the terbinafine-resistant strains isolated from the asymptomatic animals.

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Efficacy of oral terbinafine versus itraconazole in treatment of dermatophytic infection of skin – A prospective, randomized comparative study

Cited by 55 publications

References 15 publications

Sophorolipid Biosurfactant Can Control Cutaneous Dermatophytosis Caused by Trichophyton mentagrophytes

Sophorolipid Biosurfactant Can Control Cutaneous Dermatophytosis Caused by Trichophyton mentagrophytes

Tinea corporis: an updated review

Intrinsic resistance to terbinafine among human and animal isolates of Trichophyton mentagrophytes related to amino acid substitution in the squalene epoxidase

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