Limited effectiveness of four oral antifungal drugs (fluconazole, griseofulvin, itraconazole and terbinafine) in the current epidemic of altered dermatophytosis in India: results of a randomized pragmatic trial.

The British Journal of Dermatology
Sanjay SinghRagini Tilak

Abstract

Dermatophytic infections have undergone unprecedented changes in India in the recent past. Clinical trials to find out the effectiveness of the four main oral antifungal drugs are lacking. We tested the effectiveness of oral fluconazole, griseofulvin, itraconazole and terbinafine in chronic and chronic relapsing tinea corporis, tinea cruris and tinea faciei in an investigator-initiated, randomized, pragmatic trial. Two hundred patients with microscopy-confirmed tinea were allocated to four groups (50 patients in each group): fluconazole 5 mg kg-1 per day, griseofulvin 10 mg kg-1 per day, itraconazole 5 mg kg-1 per day and terbinafine 7·5 mg kg-1 per day. Allocation was performed by concealed block randomization and the patients were treated for 8 weeks or until cure. Effectiveness was calculated based on intention-to-treat analysis. The trial was registered with the Clinical Trials Registry India (CTRI/2017/04/008281). At 4 weeks, all drugs were similarly ineffective, with cure rates being 8% or less (P = 0·42). At 8 weeks, the numbers of patients cured were as follows: fluconazole 21 (42%), griseofulvin seven (14%), itraconazole 33 (66%) and terbinafine 14 (28%) (P < 0·001). Itraconazole was superior to fluconazole, griseofulv...Continue Reading

References

Feb 20, 2007·Journal of the American Academy of Dermatology·Richard K ScherBoni E Elewski
Apr 21, 2009·BMC Research Notes·Jaya GargGopal Nath
May 17, 2011·Indian Journal of Dermatology·V ShivakumarS R Prasad
May 5, 2016·Mycoses·Antonio RezustaMaria José Revillo
Apr 4, 2017·Indian Journal of Dermatology, Venereology and Leprology·Saumya Panda, Shyam Verma
Aug 11, 2017·Indian Journal of Dermatology·P Ravindra BabuBhavesh Kotak
Jun 13, 2018·Indian Journal of Dermatology, Venereology and Leprology·Sanjay Singh, Prakriti Shukla
Feb 6, 2019·Indian Journal of Dermatology, Venereology and Leprology·Sanjay SinghNarendra Kumar Tiwary

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Citations

Jul 31, 2020·The British Journal of Dermatology·B Elewski
Feb 18, 2021·Dermatologic Therapy·Ananta KhuranaKhushboo Sethia
Dec 24, 2020·American Journal of Clinical Dermatology·Aditya K GuptaVincent Piguet
Jul 6, 2021·Indian Journal of Dermatology, Venereology and Leprology·Shyam B VermaResham Vasani

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