Long term follow up of onychomycosis treated with systemic agents

NewsBot · Mar 24, 2010

Members do not see these Ads. Sign Up.
Long-term follow-up of toenail onychomycosis caused by dermatophytes after successful treatment with systemic antifungal agents.
Piraccini BM, Sisti A, Tosti A.
J Am Acad Dermatol. 2010 Mar;62(3):411-4.

BACKGROUND: Recurrences (relapse or reinfection) of onychomycosis are not uncommon, with percentages reported in various studies ranging from 10% to 53%. OBJECTIVE: We sought to determine the prevalence of long-term recurrences of toenail onychomycosis caused by dermatophytes cured after systemic antifungal treatment with terbinafine (T) or itraconazole (I) and identify risk factors for recurrences.

METHODS: This 7-year prospective study, started in 2000 and ended in 2007, included 73 patients periodically followed after successful treatment of toenail onychomycosis using either T, 250 mg daily (59 patients), or I, 400 mg daily, for 1 week per month (14 patients). Patients were evaluated every 6 months, with clinical and mycological evaluations being performed.

RESULTS: Twelve of 73 patients (16.4%) developed a recurrence of onychomycosis a mean time of 36 months after successful treatment. These included 5 of the 14 patients (35.7%) who had taken I and 7 of the 59 (11.9%) who had taken T (P = .046).

LIMITATIONS: The number of patients treated with T (59 patients) was more than that for I (14 patients).

CONCLUSION: The administration of systemic T to treat the first episode of onychomycosis may provide better long-term success than I in those patients with a complete response. Other factors including the presence of predisposing factors, use of nail lacquer as a prophylactic treatment, and the dermatophyte strain isolated were not significantly related to relapse.
Click to expand...

Admin2 · Mar 24, 2010

Related threads:
Other threads tagged with onychomycosis

misriko · Apr 11, 2010

so please what other alternatives are out there for o/m nails? after having tried lacquer treatment, terbinafine tablets what else as a clinician can be used if no success is noted. furthermore some of my patients reported side effects from the tablets andf thus discontinued treatment but still expect some form of treatment, HELP ANYONE?

Jose Antonio Teatino · Apr 11, 2010

misriko said: ↑

so please what other alternatives are out there for o/m nails? after having tried lacquer treatment, terbinafine tablets what else as a clinician can be used if no success is noted. furthermore some of my patients reported side effects from the tablets andf thus discontinued treatment but still expect some form of treatment, HELP ANYONE?
Click to expand...

Dear Colleague:
Faced with frequent relapse, if the nail is painful, or to prevent contamination of healthy nails, the complete removal of the nail plate would be indicated.
For example, a complete chemical matriceptomía.
Regards:

Jose Antonio Teatino
Professor of Surgery
The Academy Ambulatory Foot & Ankle Surgery

NewsBot · Jul 31, 2013

Recurrences of dermatophyte toenail onychomycosis during long-term follow-up after successful treatments with mono- and combined therapy of terbinafine and itraconazole.
Gupta AK, Cooper EA, Paquet M.
J Cutan Med Surg. 2013 May-Jun;17(3):201-6.

BACKGROUND:
The influence of dosing regimens on the recurrence rates of onychomycosis has not been investigated.
OBJECTIVE:
To compare recurrence rates for toenail dermatophyte onychomycosis between four dosing regimens.
METHODS:
A prospective, investigator-blinded, long-term follow-up (1.25 to 7 years postenrolment) study of the following regimens was undertaken with or without booster therapy at week 36: overlapping continuous itraconazole and terbinafine (COMBO), continuous terbinafine (CTERB), intermittent terbinafine (TOT), and pulsed itraconazole (III).
RESULTS:
One hundred six mycologically and 43 completely cured participants at week 48 were included. Recurrence rates (RR) for mycologically and completely cured participants were respectively termed mycologic recurrence (MRR) and complete cure recurrence (CRR) rates. No statistically significant difference was detected between the four regimens for the two rates. However, lower MRRs were obtained for CTERB (32%) and TOT (36%) compared to III (59%) and COMBO (57%). When participants who received booster therapy were excluded from the analysis, the MRR was lower for CTERB (21%) compared to TOT (39%).
CONCLUSIONS:
Itraconazole therapy was associated with higher RRs than terbinafine therapy. Combined therapy did not reduce the RRs compared to monotherapies. A difference might exist between continuous and intermittent antifungal regimens, but additional randomized clinical trials are needed for confirmation.
Click to expand...

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

misriko Member

Jose Antonio Teatino Well-Known Member

NewsBot The Admin that posts the news.

Long term follow up of hallux rigidus surgery

Long term impact of the COVID-19 pandemic on the education of Podiatry students

Long Term Casual Podiatrist Wanted - Paddington, Brisbane

Immediate and Short-Term Effects of Short- and Long-Duration Isometric Contractions in Patellar Tend

foot orthoses; why not for long-term load management

Long-Term Prognosis of Plantar Fasciitis

Long term problem please help me out!

Share This Page