TREATMENT OF DERMATOPHYTE NAIL INFECTIONS - AN OPEN RANDOMIZED STUDY COMPARING INTERMITTENT TERBINAFINE THERAPY WITH CONTINUOUS TERBINAFINETREATMENT AND INTERMITTENT ITRACONAZOLE THERAPY

Background: Terbinafine persists in the nail at effective concentratio ns for several weeks after discontinuation of treatment. Objective: Ou r purpose was to verify whether intermittent terbinafine therapy is ef fective in dermatophytic onychomycosis and to compare the results of i ntermittent terbinafine with those of intermittent itraconazole and co ntinuous terbinafine treatment. Methods: An open, randomized study of 63 patients was performed with three treatment regimens: terbinafine, 250 mg daily (21 patients); terbinafine, 500 mg daily for 1 week every month (21 patients); or itraconazole, 400 mg daily for 1 week every m onth (21 patients). Treatment was continued for 4 months in toenail in fections (60 patients) and 2 months in fingernail infections (3 patien ts). Results: At the end of the follow-up period (6 months after disco ntinuation of treatment) 16 of 17 patients (94.1%) with toenail onycho mycosis were mycologically cured in the terbinafine 250 mg group, 16 o f 20 (80%) in the terbinafine 500 mg group, and 15 of 20 (75%) in the itraconazole group. Conclusion: The percentage of patients who were my cologically cured was higher in the continuous terbinafine group than in the intermittent terbinafine and itraconazole groups, but statistic al analysis did not reveal any significant difference between these cu re rates.