Intermittent pulse-dosed terbinafine in the treatment of tinea corporis and/or tinea cruris

Shivakumar, V; Okade, Rajendra; Rajkumar, V; Sajitha, K; Prasad, SR

doi:10.4103/0019-5154.77579

Cited by 11 publications

(9 citation statements)

References 4 publications

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“…Terbinafine was highly effective against C. albicans and C. tropicalis strains with MIC values 2.5 and 5 µg/ml, respectively, as shown in Table 7. Similar results have been reported by several researchers and hence terbinafine is the first drug of choice in treatment of infections caused by dermatophytes [41,42]. Antifungal resistance of C. glabrata to all antifungal agents tested in the current study may be attributed to its ability to form biofilms [43].…”

Section: Discussionsupporting

confidence: 90%

In vitro antifungal resistance profile of Candida strains isolated from Saudi women suffering from vulvovaginitis

et al. 2020

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Background: Vulvovaginal candidiasis (VVC) represents a universal health hazard that contributes to significant morbidity in women. Resistance of Candida to antifungal therapy has been reported as a public health problem. So, the objective of our current study is to detect resistance profile of different candidal strains. Methods: In this study, isolated Candida strains were identified by conventional methods, confirmed by internal transcribed spacer (ITS) sequencing, and phylogenetically analyzed with reference strains in GenBank. Also, sensitivity of different Candida strains to common antifungal agents was evaluated by disc diffusion method. Results: Candida albicans was identified as the most frequent strain (63%) followed by non-albicans strains, such as C. glabrata (20%), C. tropicalis (13%), and C. krusei (4%). Sensitivity of Candida strains (C. albicans, C. tropicalis and C. glabrata) to commonly used antifungal agents was evaluated through the disc diffusion method. C. glabrata was the most resistant strain and considered to be a multidrug-resistant pathogen, while both, C. albicans and C. tropicalis showed high susceptibility to terbinafine. In contrast, C. albicans showed resistance to fluconazole, clotrimazole, and nystatin, while C. tropicalis, considered as the most sensitive strain, was susceptible to all the antifungal agents tested except nystatin. Terbinafine was the most effective antifungal agent against both C. tropicalis and C. albicans, and hence its minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) for C. albicans and C. tropicalis were evaluated. MICs of terbinafine against C. albicans and C. tropicalis were 5 μg/ml and 2.5 μg/ml, while their MFCs were 10 μg/ml and 5 μg/ml, respectively. Conclusion: The emergence of resistant Candida strains necessitates conduction of the antifungal susceptibility test prior to deciding the medication regime.

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Section: Discussionsupporting

confidence: 90%

In vitro antifungal resistance profile of Candida strains isolated from Saudi women suffering from vulvovaginitis

et al. 2020

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“…A comparative study by Amit et al (2013) found that terbinafine showed slightly better results than fluconazole in tinea corporis [17]. Terbinafine was reported to have 91% cure rate in tinea corporis and cruris patients, by a study conducted by Shivakumar et al (2011) Nevertheless, the finding in our study does not imply that itraconazole is less efficacious than terbinafine [18]. Such a finding could be ascribed to the fact that patients often could not afford itraconazole and hence discontinued the medications without clinician's opinion.…”

Section: Discussioncontrasting

confidence: 65%

Prescription Audit of Anti-fungal Treatment of Dermatophytoses in the Dermatology Out Patient Department of a Tertiary Care Hospital

2019

IJCED

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Aims: To study the prescriptions of clinically diagnosed cases of dermatophytoses, to evaluate medical treatment of clinical failure cases, any rise in serum ALT (Alanine aminotransferase) levels associated with usage of oral anti-fungal drugs, availability of drugs in the hospital pharmacy and cost minimization of different oral treatment regimens with Griseofulvin, Fluconazole, Itraconazole and Terbinafine. Settings and design: Dermatology Out Patient Department (OPD) of a tertiary care hospital, single centre prospective cohort observational study. Materials and Methods: 370 patients from the Dermatology Out Patient Department (OPD) diagnosed of dermatophytoses were enrolled. Follow-up was done 3±1 weeks apart, twice for newly diagnosed patients and once for patients on ongoing therapy. Two separate blood samples were collected 3±1 weeks apart for estimation of serum ALT. The prime lesion in each patient was graded as mild, moderate and severe. Patients were categorized as clinically cured, clinically improved, or as clinical failure following treatment. Statistical analysis used: Descriptive statistics, Fischer’s exact test and Wilcoxon’s signed rank test. Results: Azoles were the most commonly prescribed antifungals. Clinical status of patients was independent of the oral antifungal drug received (p > 0.05). A statistically significant difference in clinical status between compliant and non-compliant patients was seen (p < 0.05). A statistically significant increase in serum ALT levels was seen (p < 0.05) however, it was not clinically significant. 55.52% of drugs were unavailable in the hospital formulary. The average expenses per prescription was approximately INR 1123.55. Itraconazole was the most expensive treatment regimen followed by terbinafine and fluconazole. Conclusions: There exists a non-uniformity in the management of dermatophytoses due to lack of adequate guidance and nonavailability of drugs and clinical cure of patients depends upon compliance to therapy.

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“…[ 3 31 ] Even with an intermittent pulse dose therapy cure rates of around 90% have been reported with terbinafine. [ 32 ] Even recent in vitro studies demonstrate excellent susceptibility of dermatophytes to terbinafine. [ 33 ] However, these results are in contrast to what we experienced in our patients of tinea cruris and corporis treated with oral terbinafine.…”

Section: Discussionmentioning

confidence: 99%

Relapse after oral terbinafine therapy in dermatophytosis: A clinical and mycological study

et al. 2016

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Background:The incidence of recurrent tinea infections after oral terbinafine therapy is on the rise.Aim:This study aims to identify the appearance of incomplete cure and relapse after 2-week oral terbinafine therapy in tinea corporis and/or tinea cruris.Materials and Methods:A total of 100 consecutive patients clinically and mycologically diagnosed to have tinea corporis and/or tinea cruris were included in the study. The enrolled patients were administered oral terbinafine 250 mg once daily for 2 weeks. All clinically cured patients were then followed up for 12 weeks to look for any relapse/cure.Results:The common dermatophytes grown on culture were Trichophyton rubrum and Trichophyton tonsurans in 55% and 20% patients, respectively. At the end of 2-week oral terbinafine therapy, 30% patients showed a persistent disease on clinical examination while 35% patients showed a persistent positive fungal culture (persisters) at this time. These culture positive patients included all the clinically positive cases. Rest of the patients (65/100) demonstrated both clinical and mycological cure at this time (cured). Over the 12-week follow-up, clinical relapse was seen in 22 more patients (relapse) among those who had shown clinical and mycological cure at the end of terbinafine therapy. Thus, only 43% patients could achieve a long-term clinical and mycological cure after 2 weeks of oral terbinafine treatment. Majority of the relapses (16/22) were seen after 8 weeks of completion of treatment. There was no statistically significant difference in the body surface area involvement or the causative organism involved between the cured, persister, or relapse groups.Conclusions:Incomplete mycological cure as well as relapse is very common after standard (2-week) terbinafine therapy in our patients of tinea cruris/corporis.

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Intermittent pulse-dosed terbinafine in the treatment of tinea corporis and/or tinea cruris

Cited by 11 publications

References 4 publications

In vitro antifungal resistance profile of Candida strains isolated from Saudi women suffering from vulvovaginitis

In vitro antifungal resistance profile of Candida strains isolated from Saudi women suffering from vulvovaginitis

Prescription Audit of Anti-fungal Treatment of Dermatophytoses in the Dermatology Out Patient Department of a Tertiary Care Hospital

Relapse after oral terbinafine therapy in dermatophytosis: A clinical and mycological study

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