Evaluation of efficacy and safety of oral terbinafine and itraconazole combination therapy in the management of dermatophytosis

Value Added Abstract

Priyanka Sharma, Mala Bhalla,

Abstract

Background: Dermatophytosis represents one of the most common dermatological diseases affecting 20-25% of the world’s population, with a rapid upsurge in atypical cases with bizarre clinical as well as therapeutic behaviour in the recent years worldwide. The conventional treatment guidelines seem to fail tremendously in the management of these infections and current treatment approach is largely subjective and experience based. Objective: To evaluate the efficacy and safety of oral terbinafine and itraconazole combination therapy in the management of dermatophytosis. Methods: Clinically diagnosed and KOH positive patients of tinea corporis/cruris/faciei were randomly divided into three groups and given terbinafine 250 mg, itraconazole 200 mg and a combination of both once daily taken on the same day respectively for 3 weeks. Partial responders at the end of the therapy were given same treatment for additional 3 weeks. Clinical parameters namely itching, erythema, and scaling were evaluated at baseline, 3, 6 and 9 weeks. Adverse effects were noted at the end of therapy. Results: Maximum clinical and mycological cure was achieved in group III (receiving combination therapy) (90%) followed by group II (receiving itraconazole) (50%) and group I (receiving terbinafine) (35%). The combination therapy of oral terbinafine and itraconazole was found to be as safe as monotherapy without any significant adverse effects. Conclusions: The combination of systemic terbinafine and itraconazole therapy may be an effective and safe therapeutic strategy in the management of dermatophytosis.

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