Hi all
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Would like some opinions on what options would be suitable for a patient.
A 32 year old woman with a long history of tinea pedis and onychomycosis with several nails involved (previously confirmed on culture) She has had 12 months on oral terbinafine which while producing a definite change in nail growth has not apparently resolved the infection. No picture yet I'm afraid (sorry mortal sin on dermatology thread :eek: ) but the nails do not look like 'normal' post infection nail damage- definitely still look fungal with changes in nail quality.
Both GP and myself are reluctant to continue with terbinafine, as aside from any potential side effects it would seem somewhat pointless if it is not working.
So questions are: what are current thoughts on prevalence of terbinafine resistance and is this often tested for in these cases?
And out of the newer antifungals what would be other medications of choice?
Any thoughts on this would be appreciated
Thanks
Ian
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