Treatment of dermatophyte toenail onychomycosis with itraconazole

Abstract

Background: Onychomycosis is fungal infection of nail. The prevalence of onychomycosis varies across the world. It is lower in tropical countries (3.8%) than in sub-tropical countries and countries in the temperate zone (23%). The risk of onychomycosis is higher in persons with diabetes mellitus and human immunodeficiency virus infection. Systemic antifungals are recommended for treatment. Topical antifungals are less effective. Different cure rates have been reported by different authors for terbinafine, itraconazole and fluconazole therapy. A variety of regimens (continuous or pulse) have also been suggested.Methods: Here in this study we report a prospective, observational, cohort study of pulse itraconazole therapy in toenail onychomycosis caused by dermatophytes over a period of one year in patients with SCIO scores between 6 to 9.Results: It was observed that mean age of patients was 38.96 years. 57.27 % study subjects had complete clinical improvement to oral itraconazole three pulses regimen. One pulse consisted of 200 mg twice per day given for one week, followed by a three weeks interval. Thus, this regimen was repeated thrice.Conclusions: This study shows the substantial benefit with itraconazole pulse regimen in toenail onychomycosis. The outcome this study is comparable with previously published data and may encourage the usage of itraconazole pulse regimen for the treatment of dermatophyte toenail onychomycosis in adults.