Efficacy and safety of different terbinafine regimens in patients of recurrent tinea corporis and cruris
International Journal of Basic & Clinical Pharmacology: Published on July 2021
Superficial Tinea corporis is said to be recurrent when there is recurrence of the disease within 6 weeks after the completion of treatment. The prevalence of superficial mycosis is on the rise with change in spectrum of infection and isolation of some uncommon species.
Patients are presenting with atypical, widespread, extremely symptomatic lesions of tinea and suffer from frequent relapses after weeks of stopping treatment leading to significant impairment in quality of life.
Terbinafine is considered drug of choice for dermatophytosis with favourable pharmacokinetic and mycological profile.
Recently, there is an increase in the incidence of terbinafine resistance with increasing numbers of clinical failures and relapses when given in standard dose.
TAKE HOME MESSAGE:
Due to absence of proper treatment guidelines for the management of recurrent corporis and cruris, dermatologists are using various combinations of oral antifungals, higher doses, longer duration which is nothing but hit and trial method rather than evidence-based approach.
Therefore, this study was conducted to compare different terbinafine regimens to establish which regimens reduces the treatment failure rates and is safe and efficacious
Sixty patients with clinically and mycologically diagnosed recurrent tinea corporis and cruris were enrolled and divided into three groups.
Group A was administered oral terbinafine 500 mg once daily for 2 weeks,
Group B was given terbinafine 250 mg once daily for double duration i.e., 4 weeks, and
Group C was given standard treatment which is 250 mg once daily for 2 weeks.
At the end of 6 weeks, reduction from baseline was (A) 46.5%, (B) 95.8%, and (C) 20.4% in groups with double dose, double duration and standard therapy respectively with statistically significant improvement in group with double duration.
Mycological cure at the end of 4 weeks was (A) 80%, (B) 100% and (C) 50%. There was no safety concern in any of the groups.
Terbinafine when given in longer duration is safe, more efficacious as compared to increased dose or standard therapy in patients of recurrent tinea corporis and cruris.
Doctors Liked to Read More
Background: Tinea corporis and cruris is said to be recurrent when there is relapse of sign and symptoms after 6 weeks of cure. Recently, there has been increase in cases of recurrent tinea corporis and cruris, with atypical lesions. This study was done to establish efficacy and safety of different terbinafine regimens against recurrent tinea corporis and cruris.
Methods: Sixty patients with clinically and mycologically diagnosed recurrent tinea corporis and cruris were enrolled and divided into three groups. Group A was administered oral terbinafine 500 mg once daily for 2 weeks, group B was given terbinafine 250 mg once daily for double duration i.e., 4 weeks, and group C was given standard treatment which is 250 mg once daily for 2 weeks. Physician assessment four-point scale (PA4PS) and KOH wet mount were assessed for clinical and mycological efficacy. Biochemical laboratory parameters (liver function tests and kidney function tests) and adverse drug reactions were assessed for safety.
Results: At the end of 6 weeks, reduction in PA4PS from baseline was 46.5%, 95.8%, and 20.4% in groups with double dose, double duration and standard therapy respectively with statistically significant improvement in group with double duration. Mycological cure at the end of 4 weeks was 80%, 100% and 50%. There was no safety concern in any of the groups.
Conclusions: Double duration of terbinafine was found to be more efficacious and safer.
Comments
You must login to write comment