Treatment of Dermatophytic Onychomycosis with Intermittent and Continuous Terbinafine Regimens

The treatment of onychomycosis is a difficult and long-standing course because of the relatively low success and high recurrence rates and the necessity of laboratory monitoring for the traditional oral antifungal agents. The introduction of newer systemic antifungal drugs such as triazoles (itraconazole and fluconazole) and allylamines (terbinafine) offer an increased cure rate, a broader spectrum of activity, shortening of the treatment period, and increased safety, compared with the traditional systemic antifungal drugs (griseofulvin and ketoconazole). Preliminary results suggest that terbinafine is promising in the treatment of onychomycosis, although its spectrum of activity is not as broad as that of itraconazole. Terbinafine persists in the nails at effective concentrations for a long time even after discontinuation of treatment. An open randomized study was planned to compare the efficacy of intermittent and continuous terbinafine regimens. The clinical and microscopic cure rates were higher in the continuous group than in the intermittent group, but the differences between two groups were not statistically significant. It is suggested that continuous terbinafine regimen should be preferred in the treatment of dermatophytic onychomycosis. [Journal of Turgut Özal Medical Center 1997;4(2):135-138]