scholarly journals Futility of combining griseofulvin and terbinafine in current epidemic of altered dermatophytosis in India: Results of a randomized pragmatic trial

2019 ◽  
Author(s):  
Sanjay Singh ◽  
Vinayak N Anchan ◽  
Radhika Raheja
Keyword(s):  
Pragmatic Trial ◽  
Tinea Corporis ◽  
Number Needed To Treat ◽  
Recent Past ◽  
Cure Rate ◽  
Once Daily ◽  
Tinea Cruris ◽  
Tinea Faciei ◽  
Treatment Responsiveness ◽  
Oral Terbinafine

AbstractBackgroundTreatment responsiveness of tinea has decreased considerably in recent past in India. We tested effectiveness of oral terbinafine plus griseofulvin versus terbinafine alone in tinea corporis, tinea cruris and tinea faciei in a randomized pragmatic open trial.MethodsOne hundred and thirty two microscopy confirmed patients were randomly allocated (ratio 1:1) to two groups, terbinafine (T) and terbinafine plus griseofulvin (T+G). Doses given were as follows: T, oral terbinafine (6 mg/kg/day, maximum 500 mg/day, once daily); T+G, terbinafine (as above) plus oral griseofulvin (children [<18 years] 10 mg/kg/day, adults [18 years or more] 10 mg/kg/day, but not <500 mg and not >1000 mg per day, in two divided doses). Patients were treated for 8 weeks or cure, whichever occurred earlier.ResultsAt 4 weeks, none of the patients were cured in both groups. At 6 weeks, 1(1.5%) and 4 (6.1%) patients were cured in T and T+G groups, respectively (P=0.417). At 8 weeks, 17 (25.8%) and 19 (28.8%) patients were cured in T and T+G groups, respectively (P=0.845). For cure rate at 8 weeks, number needed to treat (NNT) for T+G (versus T), was 33.ConclusionsAddition of griseofulvin to terbinafine does not increase effectiveness of terbinafine in current epidemic of altered dermatophytosis in India.

scholarly journals Multidrug therapy with terbinafine plus daily fluconazole is more effective than terbinafine alone or terbinafine plus weekly fluconazole in current epidemic of altered dermatophytosis in India: Results of a randomized pragmatic trial

2019 ◽  
Author(s):  
Sanjay Singh ◽  
Bandana Jha ◽  
Prakriti Shukla ◽  
Vinayak N Anchan
Keyword(s):  
Pragmatic Trial ◽  
Number Needed To Treat ◽  
Multidrug Therapy ◽  
Recent Past ◽  
Number Of Patients ◽  
Cure Rates ◽  
Tinea Faciei ◽  
Treatment Responsiveness ◽  
Relapse Rates ◽  
Oral Terbinafine

AbstractBackgroundTreatment responsiveness of tinea has decreased considerably in recent past in India. We tested effectiveness of oral terbinafine daily plus fluconazole weekly (TFw) and terbinafine daily plus fluconazole daily (TFd) versus oral terbinafine daily (T) in tinea corporis, tinea cruris and tinea faciei in a pragmatic randomized open trial.MethodsOne hundred and seventeen microscopy confirmed patients were allocated to T (6 mg/kg/day), TFw (terbinafine 6 mg/kg/day+fluconazole 12 mg/kg once weekly), or TFd (terbinafine 6 mg/kg/day+fluconazole 6 mg/kg/day) groups by concealed randomization and treated for 8 weeks or cure. Each group included 39 patients.ResultsAt 4 weeks, 9 (23.1%), 8 (20.5%) and 14 (35.9%) patients were cured in T, TFw and TFd groups, respectively (P=0.279). At 8 weeks, number of patients cured was as follows: T 13 (33.3%), TFw 18 (46.2%) and TFd 25 (64.1%). TFd was more effective than T (P=0.012), other comparisons were not significantly different. However, effect size as calculated by number needed to treat (NNT) (versus terbinafine) was 8 for TFw and 4 for TFd. Relapse rates one month after cure were similar in all groups (P=0.664).ConclusionsIn view of cure rates and NNT, terbinafine plus daily fluconazole is more effective than terbinafine alone or terbinafine plus weekly fluconazole in current epidemic of altered dermatophytosis in India.One Sentence SummaryTerbinafine plus daily fluconazole is more effective than terbinafine alone or terbinafine plus weekly fluconazole in current epidemic of altered dermatophytosis in India.

scholarly journals Multidrug therapy with terbinafine and itraconazole is not superior to itraconazole alone in current epidemic of altered dermatophytosis in India: A randomized pragmatic trial

2019 ◽  
Author(s):  
Sanjay Singh ◽  
Vinayak N Anchan ◽  
Usha Chandra ◽  
Radhika Raheja
Keyword(s):  
Pragmatic Trial ◽  
Number Needed To Treat ◽  
Multidrug Therapy ◽  
Control Versus ◽  
Oral Itraconazole ◽  
Cure Rates ◽  
Tinea Faciei ◽  
Treatment Responsiveness ◽  
Relapse Rates ◽  
Oral Terbinafine

AbstractBackgroundTreatment responsiveness of dermatophytosis has decreased considerably in recent past in India. We compared effectiveness of oral terbinafine daily (Terb) (active control) versus itraconazole daily (Itra) versus terbinafine plus itraconazole daily (TI) versus terbinafine daily plus itraconazole pulse (TIp) in tinea corporis, tinea cruris and tinea faciei in a pragmatic randomized open trial.MethodsNinety-two microscopically confirmed patients were allocated to Terb (6 mg/kg/day), Itra (5 mg/kg/day), TI (terbinafine 6 mg/kg/day, itraconazole 5 mg/kg/day), or TIp (terbinafine 6 mg/kg/day, itraconazole 10 mg/kg/day for 1 week in 4 weeks) group by concealed block randomization and treated for 8 weeks or cure.ResultsCure rates were similar at 4 weeks (P=0.768). At 8 weeks, 5 (21.7%), 18 (78.3%), 16 (69.6%), and 16 (69.6%) patients were cured in Terb, Itra, TI, and TIp groups, respectively. All experimental regimens (Itra, TI, TIp) were more effective than Terb (P≤0.0027). All experimental regimens had similar effectiveness (P≥0.738). Relapse rates 4 and 8 weeks after cure were similar (P=0.869 and 0.314, respectively). Number-needed-to-treat (NNT) was 2 for Itra, 3 for TI, and 3 for TIp.ConclusionsOral itraconazole given daily (NNT=2) is the most effective treatment and combining it with terbinafine does not increase effectiveness.One Sentence SummaryCombination of oral terbinafine and itraconazole is not more effective than itraconazole alone in current epidemic of altered dermatophytosis in India.

scholarly journals A Comparative Study of Safety and Efficacy of Oral Terbinafine and Itraconazole in Patients of Tinea Corporis/ Tinea Cruris Infection, A Randomized Open Label Parallel Group Study

2021 ◽  
Vol 14 (3) ◽  
pp. 1543-1549
Author(s):  
S. Brigida ◽  
Arul Amutha Elizabeth ◽  
G. Soujania ◽  
R. Poornima Poornima
Keyword(s):  
Public Health Problem ◽  
Tinea Corporis ◽  
Open Label ◽  
Once Daily ◽  
Safety And Efficacy ◽  
Tinea Cruris ◽  
Oral Itraconazole ◽  
Group 2 ◽  
Oral Terbinafine ◽  
Group 1

Introduction: Superficial dermatophytosis is a common public health problem in India, due to its tropical climate with heat and humidity. Today, the triazoles, mainly Itraconazole and the allylamines, chiefly Terbinafine, are the main ammunitions against dermatophytes. This study is undertaken to compare the safety and efficacy of both the drugs. Materials and Methods: This study was conducted to find the efficacy of Oral Terbinafine and Oral Itraconazole in Tinea Corporis/Tinea Cruris infection. The primary efficacy parameter was change in composite score (pruritus, erythema, pigmentations) from baseline to end of the treatment period. And to compare the safety of Oral Terbinafine and Oral Itraconazole by comparing the following parameters, Liver enzymes - SGOT/SGPT before and after treatment with the study drugs. Drug Dosage: Group 1: Drug –Tab. Terbinafine: Dose 500 mg per day once daily at bedtime for 2 weeks. Group 2: Drug –Tab. Itraconazole: Dose 200 mg per day, once daily at bedtime for 2 weeks. Results: The study participants show significant reduction in itching at the second follow up (after 2 weeks of drug completion) in both groups. Pruritis was reduced in 92% subjects in group 1 and 97.5% subjects in group 2. There was 87% reduction in erythema in group 1 and 93% reduction in group 2. Pigmentations were seen in 2% subjects in both groups indicating relapse of infection. Conclusion: The significant outcome of the study was that oral Itraconazole 200mg/day for 14 days(2 weeks) can be the better antifungal.

Guidelines of care for superficial mycotic infectionsof the skin: Tinea corporis, tinea cruris, tinea faciei, tinea manuum, and tinea pedis

1996 ◽  
Vol 34 (2) ◽  
pp. 282-286 ◽  
Author(s):  
Lynn A. Drake ◽  
Scott M. Dinehart ◽  
Evan R. Farmer ◽  
Robert W. Goltz ◽  
Gloria F. Graham ◽  
...  
Keyword(s):  
Tinea Pedis ◽  
Tinea Corporis ◽  
Tinea Cruris ◽  
Tinea Faciei

Once-Daily Naftifine Cream 1% in the Treatment of Tinea Cruris and Tinea Corporis

1990 ◽  
Vol 29 (6) ◽  
pp. 441-442 ◽  
Author(s):  
Robert E. Jordon ◽  
Ronald P. Rapini ◽  
Ira H. Rex ◽  
H. Irving Katz ◽  
Janet G. Hickman ◽  
...  
Keyword(s):  
Tinea Corporis ◽  
Once Daily ◽  
Tinea Cruris

scholarly journals Effectiveness of four oral antifungal drugs (fluconazole, griseofulvin, itraconazole, terbinafine) in current epidemic of altered dermatophytosis in India: A randomized pragmatic trial

2019 ◽  
Author(s):  
Sanjay Singh ◽  
Usha Chandra ◽  
Priyanka Verma ◽  
Vinayak N Anchan ◽  
Ragini Tilak
Keyword(s):  
Pragmatic Trial ◽  
Antifungal Drugs ◽  
Recent Past ◽  
Oral Fluconazole ◽  
Intention To Treat ◽  
Numbers Needed To Treat ◽  
Cure Rates ◽  
Tinea Faciei ◽  
Relapse Rates ◽  
Treat Analysis

AbstractBackgroundDermatophyte infections have undergone unprecedented changes in India in recent past. Clinical trials comparing effectiveness of 4 main oral antifungal drugs are not available. We tested effectiveness of oral fluconazole, griseofulvin, itraconazole and terbinafine in chronic and chronic-relapsing tinea corporis, tinea cruris and tinea faciei.MethodsTwo hundred microscopy confirmed patients were allocated to 4 groups, fluconazole (5mg/kg/day), griseofulvin (10 mg/kg/day), itraconazole (5mg/kg/day), and terbinafine (7.5mg/kg/day), by concealed block randomization and treated for 8 weeks or cure. Effectiveness was calculated based on intention to treat analysis.ResultsAt 4 weeks, 4, 1, 2, and 4 patients were cured with fluconazole, griseofulvin, itraconazole and terbinafine, respectively (P=0.417). At 8 weeks, 21 (42%), 7 (14%), 33 (66%) and 14 (28%) patients were cured, respectively (P=0.000); itraconazole was superior to fluconazole, griseofulvin and terbinafine (P≤0.016). Relapse rates after 4 and 8 weeks of cure in different groups were similar. Numbers-needed-to-treat (NNT) (versus griseofulvin), calculated based on cure rates at 8 weeks, for itraconazole, fluconazole, and terbinafine were 2, 4 and 8, respectively.ConclusionIn view of cure rates and NNT, itraconazole is the most effective drug, followed by fluconazole (daily), terbinafine and then griseofulvin, in chronic and chronic-relapsing dermatophytosis in India.One Sentence SummaryEffectiveness of all four antifungals has declined, with itraconazole being the most effective currently in dermatophytosis in India.

scholarly journals Efficacy and safety of different terbinafine regimens in patients of recurrent tinea corporis and cruris

2021 ◽  
Author(s):  
Noopur Verma ◽  
Savita Verma ◽  
Surbhi Dayal ◽  
M. C. Gupta
Keyword(s):  
Safety Concern ◽  
Liver Function Tests ◽  
Tinea Corporis ◽  
Efficacy And Safety ◽  
Once Daily ◽  
Function Tests ◽  
Biochemical Laboratory ◽  
Group A ◽  
Group B ◽  
Oral Terbinafine

Background: Tinea corporis and cruris is said to be recurrent when there is relapse of sign and symptoms after 6 weeks of cure. Recently, there has been increase in cases of recurrent tinea corporis and cruris, with atypical lesions. This study was done to establish efficacy and safety of different terbinafine regimens against recurrent tinea corporis and cruris.Methods: Sixty patients with clinically and mycologically diagnosed recurrent tinea corporis and cruris were enrolled and divided into three groups. Group A was administered oral terbinafine 500 mg once daily for 2 weeks, group B was given terbinafine 250 mg once daily for double duration i.e., 4 weeks, and group C was given standard treatment which is 250 mg once daily for 2 weeks. Physician assessment four-point scale (PA4PS) and KOH wet mount were assessed for clinical and mycological efficacy. Biochemical laboratory parameters (liver function tests and kidney function tests) and adverse drug reactions were assessed for safety.Results: At the end of 6 weeks, reduction in PA4PS from baseline was 46.5%, 95.8%, and 20.4% in groups with double dose, double duration and standard therapy respectively with statistically significant (p<0.05) improvement in group with double duration. Mycological cure at the end of 4 weeks was 80%, 100% and 50%. There was no safety concern in any of the groups.Conclusions: Double duration of terbinafine was found to be more efficacious and safer.

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