Refractory onychomycosis due to Trichophyton rubrum: combination therapy with itraconazole and terbinafine

• Main Authors: Bonifaz Alexandro, Vázquez-González Denisse, Saúl Amado, Fierro-Arias Leonel, Ponce-Olivera M. Rosa
• Format: Article
• Language: English
• Published: Our Dermatology Online 2011-07-01
• Series: Nasza Dermatologia Online
• Subjects: onychomycosis; refractory; distal subungual onychomycosis; itraconazole; terbinafine; Trichophyton rubrum
• Online Access: http://odermatol.like.pl/upload/file/2_Refractory%20onychomycosis.pdf

Objectives: Evaluate the efficacy and tolerability of itraconazole plus terbinafine for refractory onychomycosis. This is a prospective clinical trial. Patients with proven Trychophyton rubrum onychomycosis of toenails were enrolled; the treatment consisted of weekly administration: itraconazole 200mg/day and terbinafine 250mg/day, for four months. Results: Thirty-two patients with onychomycosis were studied. Twenty-eight cases had distal subungual onychomycosis and 4 total dystrophic onychomycosis. At the end of the follow-up 17/32 patients had clinical and mycologic cure (53.12%), 5 had clinical improvement only (15.6%), and 10 (31.2%) failed. Conclusion: Weekly alternate therapy with itraconazole + terbinafine represents a safe rescue treatment.