Oral therapy for onychomycosis: An evidence-based review

Daniel Coelho De Sá, Ana Paula Botto Lamas, Antonella Tosti

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Introduction: Onychomycosis is a very common fungal infection of the nail apparatus; however, it is very hard to treat, even when the causative agent is identified, and usually requires prolonged systemic antifungal therapy. Until the 1990s, oral treatment options included only griseofulvin and ketoconazole, and the cure rate was very low. New generations of antimycotics, such as fluconazole, itraconazole and terbinafine have improved treatment success. Methods: Literature was identified by performing a PubMed Ovid MEDLINE, Ovid EMBASE, EBSCO CINAHL, and Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) search. Prospective and randomized clinical trials were chosen to be included in this review. Forty-six trials were included. Results: Fluconazole, itraconazole and terbinafine are effective in the treatment of onychomycosis and have a good safety profile. When a dermatophyte is the pathogen, terbinafine produces the best results. For Candida and nondermatophyte infections, the azoles, mainly itraconazole, are the recommended therapy. Conclusion: In the majority of the studies, terbinafine treatment showed a higher cure ratio than the other drugs for dermatophyte onychomycosis.

Original languageEnglish
Pages (from-to)17-36
Number of pages20
JournalAmerican Journal of Clinical Dermatology
Volume15
Issue number1
DOIs
StatePublished - Feb 1 2014

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terbinafine
Onychomycosis
Itraconazole
Arthrodermataceae
Fluconazole
Therapeutics
Griseofulvin
Azoles
Ketoconazole
Mycoses
Nails
Candida
Hispanic Americans
PubMed
MEDLINE
Randomized Controlled Trials
Safety
Infection
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Dermatology

Cite this

Oral therapy for onychomycosis : An evidence-based review. / De Sá, Daniel Coelho; Lamas, Ana Paula Botto; Tosti, Antonella.

In: American Journal of Clinical Dermatology, Vol. 15, No. 1, 01.02.2014, p. 17-36.

Research output: Contribution to journalArticle

De Sá, Daniel Coelho ; Lamas, Ana Paula Botto ; Tosti, Antonella. / Oral therapy for onychomycosis : An evidence-based review. In: American Journal of Clinical Dermatology. 2014 ; Vol. 15, No. 1. pp. 17-36.
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