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Dermatofitik onikomikozlarda aralıklı ve devamlı terbinafin tedavisi

Treatment of Dermatophytic Onychomycosis with Intermittent and Continuous Terbinafine Regimens

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Abstract (2. Language): 
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):135-13
Abstract (Original Language): 
Tırnak mantar enfeksiyonlarının tedavisi; oldukça zor, başarı oranları nispeten düşük, tekrarlama ihtimali yüksek, uzun ve kullanılan ilaçların yan etkileri sebebiyle sık laboratuar kontrolleri gerektiren bir girmesi; tam iyileşme oranlarını yükseltmiş, etki spektrumunu genişletmiş, tedavi sürelerini kısaltmış ve yan etkileri kısmen azaltmıştır. Elde edilen ilk sonuçlar terbinafin'in, itrakonazol kadar geniş spektrumlu olmamakla beraber, onikomikoz tedavi kesildikten sonra da uzunca bir süre tırnaklarda etkili bir konsantrasyonu korumaktadır. Onikomikoz çalışmada, devamlı tedavi grubunda klinik ve mikroskopik iyileşme oranlarının aralıklı tedavi grubuna göre daha yüksek olduğunu fakat aradaki farkın istatistik açıdan anlamlı olmadığını gördük. Dermatofitik [Turgut Özal Tıp Merkezi Dergisi 1997;4(2):135-138]
135-138

REFERENCES

References: 

1. Chiritescu MM, Chiritescu ME, Scher RK. Newer systemic antifungal drugs for the treatment of onychomycosis. Clin Pod Med & Surg 1996; 13: 741-58.
2. Odom RB. New therapies for onychomycosis. J Am Acad Dermatol 1996; 35: S 26-30.
3. Alpsoy E. Yilmaz E. Basaran E. Intermittent therapy with terbinafine for dermatophyte toe-onychomycosis: a new approach. J Dermatol 1996; 23: 259-62.
4. Tosti A; Piraccini BM; Stinchi C; Venturo N; Bardazzi F; Colombo MD. Treatment of dermatophyte nail infections: an open randomized study comparing intermittent terbinafine therapy with continuous terbinafine treatment and intermittent itraconazole therapy. J Am Acad Dermatol
1996; 34: 595-600.
5. Arenas R, Dominguez-Cherit J, Fernandez LM. Open randomized comparison of itraconazole versus terbinafine in onychomycosis. Int J Dermatol 1995; 34: 138-43.
6. Albanese G, Di Cintio R, Martini C, Nicoletti A. Short
therapy for tinea unguium with terbinafine: four different courses of treatment. Mycoses 1995; 38: 211-4.
7. Shear NH, Gupta AK. Terbinafine for the treatment of pedal onychomycosis. A foot closer to the promised land of cured nails? Arch Dermatol 1995; 131: 937-42.
8. Schatz F, Brautigam M, Dobrowolski E, Effendy I, Haberl H, Mensing H, Weidinger G, Stutz A . Nail incorporation kinetics of terbinafine in onychomycosis patients. Clin Exp
Dermatol 1995; 20: 377-83.
9. Kovarik JM, Mueller EA, Zehender H, Denouel J, Caplain H, Millerioux L. Multiple-dose pharmacokinetics and distribution in tissue of terbinafine and metabolites. Antimicrob Agent Chemotherapy 1995; 39: 2738-41.
10. Faergemann J, Anderson C, Hersle K, Hradil E, Nordin P, Kaaman T, Molin L, Pettersson A. Double-blind, parallel-group comparison of terbinafine and griseofulvin in the treatment of toenail onychomycosis. J Am Acad Dermatol
1995; 32: 750-3.
11. De Backer M, De Keyser P, De Vroey C, Lesaffre E. A 12-
week treatment for dermatophyte toe onychomycosis: terbinafine 250 mg/day vs. itraconazole 200 mg/day-- a double-blind comparative trial. Br J Dermatol 1996; 134
Suppl 46:16-7.
12. Segal R. Kritzman A. Cividalli L. Samra Z. David M. Tiqva P. Treatment of Candida nail infection with terbinafine. J
Am Acad Dermatol 1996; 35: 958-61.
13. Carstens J, Wendelboe P, Sogaard H, Thestrup-Pedersen K. Toxic epidermal necrolysis and erythema multiforme following therapy with terbinafine. Acta Dermato-Venereol 1994; 74(5): 391-2.

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