Clinical results with terbinafine in onychomycosis

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Abstract
Current treatment of dermatophyte infection of the nails is unsatisfactory. A new, orally active, fungicidal agent terbinafine (Lamisil) has been used in the treatment of 103 patients with dermatophyte onychomycosis. Eighty patients with toenail infection and 23 with fingernail infection received 250 mg terbinafine daily; fingernail infections were treated for 6 months and toenail infections for 12 months. Patients were monitored monthly, and samples for mycological examination and a full biochemical and haematological profile were obtained. Of 89 patients who completed the course of therapy, 95% of patients with fingernail infection and 82% of those with toenail infection achieved mycological cure. The mean time for mycological cure was 13.4 weeks for fingernail infection, and 28 weeks for toenail infections. Gastrointestinal complaints were the commonest reason for withdrawal from the study, and together with mild CNS symptoms accounted for most of the adverse effects reported. These results show that terbinafine is an effective and well tolerated treatment for fungal nail dystrophy due to dermatophyte infection. It promises to be a major therapeutic advance in the treatment of dermtophyte infections.

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