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Terbinafine

Distribution by Scientific Domains
Medical Sciences91%
2 Other Domains9%

Kinds of Terbinafine

  • oral terbinafine
    		•

    Terms modified by Terbinafine

  • terbinafine hydrochloride
    		•

    Selected Abstracts

    Inhibition of human vascular endothelial cells proliferation by terbinafine

    INTERNATIONAL JOURNAL OF CANCER, Issue 1 2004
    Pei-Yin Ho
    Abstract We have demonstrated previously that terbinafine (TB), an oral antifungal agent used in the treatment of superficial mycosis, suppresses proliferation of various cultured human cancer cells in vitro and in vivo by inhibiting DNA synthesis and activating apoptosis. In our study, we further demonstrated that TB at a range of concentrations (0,120 ,M) dose-dependently decreased cell number in cultured human umbilical vascular endothelial cells (HUVEC). Terbinafine was not cytotoxic at a concentration of 120 ,M, indicating that it may have an inhibitory effect on the cell proliferation in HUVEC. The TB-induced inhibition of cell growth rate is reversible. [3H]thymidine incorporation revealed that TB reduced the [3H]thymidine incorporation into HUVEC during the S-phase of the cell-cycle. Western blot analysis demonstrated that the protein levels of cyclin A, but not cyclins B, D1, D3, E, CDK2 and CDK4, decreased after TB treatment. The TB-induced cell-cycle arrest in HUVEC occurred when the cyclin-dependent kinase 2 (CDK2) activity was inhibited just as the protein level of p21 was increased and cyclin A was decreased. Pretreatment of HUVEC with a p21 specific antisense oligonucleotide reversed the TB-induced inhibition of [3H]thymidine incorporation. Taken together, these results suggest an involvement of the p21-associated signaling pathway in the TB-induced antiproliferation in HUVEC. Capillary-like tube formation and chick embryo chorioallantoic membrane (CAM) assays further demonstrated the anti-angiogenic effect of TB. These findings demonstrate for the first time that TB can inhibit the angiogenesis. © 2004 Wiley-Liss, Inc. [source]

    Terbinafine, a unique oral antifungal: current perceptions

    INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2000
    Sanjeev Jain
    First page of article [source]

    Efficacy and safety of a new single-dose terbinafine 1% formulation in patients with tinea pedis (athlete's foot): a randomized, double-blind, placebo-controlled study

    JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 10 2006
    JP Ortonne
    Abstract Background, Tinea pedis is a common dermatophyte infection with frequent recurrences. Terbinafine (presently used as a 1-week topical treatment of tinea pedis) is now available in a novel topical solution (film-forming solution , FFS), developed to allow single application. Objectives, To demonstrate the efficacy and safety of terbinafine 1% FFS in a randomized, double-blind, placebo-controlled, phase III trial, and to determine relapse or re-infection rate of tinea pedis at 12 weeks. Patients/methods, Fifty-four centres (27 in France; 27 in Germany) enrolled 273 evaluable patients (2 : 1 randomization). Patients applied terbinafine 1% FFS or placebo only once between, under and over the toes, soles and sides of both feet. Efficacy assessments included direct microscopy, mycological culture, and clinical signs and symptoms at baseline, and at weeks 1, 6 and 12 after the single drug application. Results, Effective treatment (negative mycology plus absent/minimal symptoms) at week 6 in the terbinafine 1% FFS group was 63%; vehicle was 17% (P 0.0001). Mycological cure was 72% in the terbinafine group and 21% in the placebo (P 0.0001) at week 6. Clinical signs/symptoms decreased significantly in the active group compared to the placebo. The self-assessment of itching and burning sensation by the patient showed a clear reduction in symptoms starting 15 min after treatment application (this could be attributed to the cooling effect of the FFS). Recurrence (positive culture at 3 months) occurred in 12.5% of the effectively treated patients at week 6 in the terbinafine group. FFS was well tolerated. Conclusion, Terbinafine 1% FFS, single dose application is an effective, safe and convenient treatment for tinea pedis. The relapse/re-infection rate 3 months after the end of single-dose therapy is similar to that previously demonstrated in a study using terbinafine 1% cream for 7 days. [source]

    Effect of infection with Trichophyton mentagrophytes varietas interdigitale on phagocytosis in humans

    JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 2 2004
    T Gregurek-Novak
    ABSTRACT Background and aim, Phagocytosis by polymorphonuclear leucocytes (PMNLs) and macrophages is important in the defence of human organisms, especially in mycotic infections of the skin. The aim of this study was to examine the relationship between phagocytosis and a chronic type of infection with Trichophyton mentagrophytes varietas interdigitale (T. m. var. interdig.). Materials and methods, A group of 256 patients was investigated from 1990 to 2000. They were all treated with terbinafine. The parameters for phagocytosis were analysed by the Hersy method. Results, The immunological status of all of the patients was altered. Ingestion, digestion and random mobility decreased significantly (P < 0.001). Out of 256 patients treated with terbinafine, 196 (76%) were cured completely and the values for phagocytosis became normal. Conclusion, This investigation confirms the defect in the function of phagocytes of patients chronically infected by T. m. var. interdig. Terbinafine was shown to be an effective antimycotic drug, both fungicidal and immunostimulative. [source]

    In vitro antifungal susceptibility patterns of dermatophyte strains causing tinea unguium

    CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 6 2007
    E. Sarifakioglu
    Summary Background., Dermatophytes are the major responsible organisms in onychomycosis. Although recent antifungal agents have high success rates in treating this condition, lack of clinical response may occur in 20%. Antifungal drug resistance may be one of the causes of treatment failure. The need for in vitro antifungal drug resistance in daily practice is still under discussion. Objective., We aimed to determine the in vitro susceptibility patterns of dermatophytes causing onychomycosis, against the traditionally available systemic antifungal agents terbinafine, itraconazole and fluconazole. Methods., In total, 100 otherwise healthy patients with suspected onychomycosis were included. Nail clippings were cultured on Sabouraud dexrose agar, mycobiotic agar and dermatophyte test medium. Antifungal susceptibility tests were carried out, mainly following The National Committee for Clinical and Laboratory Standards (M38-P) protocol standard for filamentous fungi. Different concentrations of terbinafine (0.008,8 µg/mL), itraconazole (0.015,16 µg/mL) and fluconazole (0.06,64 µg/mL) were tested. Minimum inhibitory concentration end-point determination was chosen as 100% growth inhibition for terbinafine and 80% for azoles. Results., Of the 100 nail samples, 43% grew dermatophytes. The main causative organism was Trichophyton rubrum (91%) followed by Trichophyton mentagrophytes (9%). Terbinafine had the lowest minimum inhibitory concentration (0.008 µg/mL) followed by itraconazole. Fluconazole showed the greatest variation in minimum inhibitory concentration (0.03,2 µg/mL) and had different susceptibility patterns for the two species. Conclusions., Of the three antifungals tested, terbinafine had the most potent in vitro antifungal activity against dermatophytes. Antifungal susceptibility tests would be useful to screen antifungal-resistant dermatophyte strains. [source]

    In Candida albicans, resistance to flucytosine and terbinafine is linked to MAT locus homozygosity and multilocus sequence typing clade 1

    FEMS YEAST RESEARCH, Issue 7 2009
    Frank C. Odds
    Abstract A panel of 637 isolates of Candida albicans that had been typed by multilocus sequence typing (MLST) and tested for susceptibility to amphotericin B, caspofungin, fluconazole, flucytosine, itraconazole, ketoconazole, miconazole, terbinafine and voriconazole was the material for a statistical analysis of possible associations between antifungal susceptibility and other properties. For terbinafine and flucytosine, the greatest proportion of low-susceptibility isolates, judged by two resistance breakpoints, was found in MLST clade 1 and among isolates homozygous at the MAT locus, although only three isolates showed cross-resistance to the two agents. Most instances of low susceptibility to azoles, flucytosine and terbinafine were among oropharyngeal isolates from HIV-positive individuals. Statistically significant correlations were found between terbinafine and azole minimal inhibitory concentrations (MICs), while correlations between flucytosine MICs and azole MICs were less strong. It is concluded that a common regulatory mechanism may operate to generate resistance to the two classes of agent that inhibit ergosterol biosynthesis, terbinafine and the azoles, but that flucytosine resistance, although still commonly associated with MAT homozygosity, is differently regulated. [source]

    Inhibition of human vascular endothelial cells proliferation by terbinafine

    INTERNATIONAL JOURNAL OF CANCER, Issue 1 2004
    Pei-Yin Ho
    Abstract We have demonstrated previously that terbinafine (TB), an oral antifungal agent used in the treatment of superficial mycosis, suppresses proliferation of various cultured human cancer cells in vitro and in vivo by inhibiting DNA synthesis and activating apoptosis. In our study, we further demonstrated that TB at a range of concentrations (0,120 ,M) dose-dependently decreased cell number in cultured human umbilical vascular endothelial cells (HUVEC). Terbinafine was not cytotoxic at a concentration of 120 ,M, indicating that it may have an inhibitory effect on the cell proliferation in HUVEC. The TB-induced inhibition of cell growth rate is reversible. [3H]thymidine incorporation revealed that TB reduced the [3H]thymidine incorporation into HUVEC during the S-phase of the cell-cycle. Western blot analysis demonstrated that the protein levels of cyclin A, but not cyclins B, D1, D3, E, CDK2 and CDK4, decreased after TB treatment. The TB-induced cell-cycle arrest in HUVEC occurred when the cyclin-dependent kinase 2 (CDK2) activity was inhibited just as the protein level of p21 was increased and cyclin A was decreased. Pretreatment of HUVEC with a p21 specific antisense oligonucleotide reversed the TB-induced inhibition of [3H]thymidine incorporation. Taken together, these results suggest an involvement of the p21-associated signaling pathway in the TB-induced antiproliferation in HUVEC. Capillary-like tube formation and chick embryo chorioallantoic membrane (CAM) assays further demonstrated the anti-angiogenic effect of TB. These findings demonstrate for the first time that TB can inhibit the angiogenesis. © 2004 Wiley-Liss, Inc. [source]

    Clinical efficacy and safety of oral terbinafine in fungal mycetoma

    INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2 2006
    Bassirou N'Diaye MD
    Objectives, An open-label study was performed to assess the efficacy and safety of terbinafine in the treatment of eumycetoma. Methods, Single-center, open-label study, including 27 patients with signs and symptoms of eumycetoma which had developed within 5 years and was confirmed by mycological examination. The intention-to-treat population (n = 23) received 500 mg of terbinafine bid for 24,48 weeks. Efficacy evaluations included clinical signs and symptoms (e.g. sinuses open or closed, degree of tumefaction, and emission of grains either present or absent); mycological examinations from Week 24 onwards; and investigators' overall assessment of efficacy (cure, improved since baseline, unchanged since baseline, or deterioration since baseline). Safety evaluations included monitoring of adverse events, laboratory assessments, vital signs and physical examinations. Results, Good clinical improvement was seen in patients who completed the study (n = 20). Tumefaction was absent or improved in 80% of patients; sinuses were closed in 50% of patients, and grain emissions were absent in 65% of patients. Of the 16 patients who had repeat mycological assessment, four (25%) were mycologically cured. In the investigators' overall opinion at the end of the study, five (25%) were cured and 11 (55%) were clinically improved. The majority of adverse events reported were mild to moderate, and consistent with the known tolerability profile of terbinafine. Conclusion, High-dose terbinafine (1000 mg/day) is well tolerated and clinically effective in patients with eumycetoma, a difficult-to-treat subcutaneous mycoses. [source]

    A pilot evaluation of pulse itraconazole vs. terbinafine for treatment of Candida toenail onychomycosis,

    INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 9 2005
    Erin M. Warshaw MD
    First page of article [source]

    Tinea imbricata or Tokelau

    INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2004
    Alexandro Bonifaz MB
    Tinea imbricata (TI) or Tokelau is a superficial mycosis caused by Trichophyton concentricum, an anthropophilic dermatophyte. It is endemic in some islands of the South Pacific (Polynesia), South-East Asia, Central and South America, and Mexico, and is most often seen in individuals living in primitive and isolated conditions. The skin lesions are characteristically concentric and lamellar (imbricata: in Latin, tiled) plaques of scale. Predisposing conditions include humidity, inheritance, and immunologic factors. The diagnosis is usually made on clinical grounds, supported by skin scrapings and culture. Tokelau is a chronic and highly relapsing disease and, although no first-line treatment exists, best results are obtained with oral griseofulvin and terbinafine and a topical combination of keratolytic ointments, such as Whitfield's. TI is a disease model that allows the correlation of a series of environmental, genetic, immunologic, and therapeutic conditions. [source]

    Comparison of efficacy criteria across onychomycosis trials: need for standardization

    INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2003
    Aditya K. Gupta MD, FRCP(C)
    Background The last 10 years have seen a substantial increase in the number of studies reporting the efficacy of the various antifungal agents used to treat onychomycosis. Aim To examine the definitions of efficacy parameters reported in clinical studies on the treatment of onychomycosis and discuss the importance of standardized reporting. Methods We searched MEDLINE (1966,2001) for studies in which oral treatments, griseofulvin, ketoconazole, terbinafine (continuous and pulse), itraconazole (continuous and pulse), and fluconazole, were used to treat dermatophyte onychomycosis. Results Mycologic cure was predominantly defined as negative microscopy and culture. Unlike mycologic cure, clinical parameters (e.g. clinical response, clinical cure) were variably defined. Subjective terms, such as "cure" or "markedly improved," were used; although these terms appear to be explicit, what is considered to be "cured" or "markedly improved" by one evaluator may not be by another. Also, infected nails were clinically evaluated to determine the response to treatment. Studies measured the distance between the proximal nail fold and a notch in the nail plate, at the junction between the diseased and normal-appearing nail, or in some cases estimated the diseased nail plate involvement. Conclusions This review of the literature on systemic agents used to treat onychomycosis shows that standard and explicit definitions are required for the accurate comparison of the effectiveness of the various therapies. [source]

    Oral terbinafine for the treatment of seborrheic dermatitis in adults

    INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2002
    Nicoletta Cassano MD
    No abstract is available for this article. [source]

    Rapid response of Trichophyton tonsurans -induced onychomycosis after treatment with terbinafine

    INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2002
    Raza Aly PhD
    We describe an 8-year-old Hispanic female who presented with distal subungual onychomycosis and tinea capitis. Both foci of infection yielded Trichophyton tonsurans upon culture, and were clinically and mycologically cured with terbinafine 62.5 mg twice daily for 1 week. This aspect of treatment with terbinafine has not previously been reported. [source]

    Majocchi's granuloma trichophyticum in an immunocompromised patient

    INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2 2000
    Somesh Gupta MD
    A 40-year-old man with alcoholic liver disease was referred to the dermatology clinic for asymptomatic papulonodular lesions over the face of 15 days' duration. Cutaneous examination revealed multiple, dusky red to yellow, follicular as well as perifollicular papulonodular lesions, varying in size from 0.5 to 2 cm ( Fig. 1). They were distributed over the forehead, cheeks, eyelids, nose, chin, beard area, retroauricular area, and neck. Careful examination revealed well-defined scaly margins on the back of the pinna ( Fig. 2). KOH examination of a scraping from the neck revealed nonpigmented septate hyphae. Histopathologic examination of the excised nodule revealed epitheloid cell granulomas with neutrophilic microabscesses surrounding the hair follicles. Periodic acid,Schiff stain was noncontributory. Culture of an excised nodule on Sabouraud's agar showed growth of Trichophyton rubrum. Considering his liver disease, the patient was initially treated with topical terbinafine. Because of a lack of a satisfactory response this was changed to oral terbinafine 250 mg/day. There was marked regression of the lesions by the sixth day. Unfortunately, the patient succumbed to complications relating to his liver disease. Figure 1. Follicular and perifollicular lesions of Majocchi's granuloma Figure 2. A well-defined scaly margin of tinea on the back of the pina [source]

    The microencapsulation of terbinafine via in situ polymerization of melamine-formaldehyde and their application to cotton fabric

    JOURNAL OF APPLIED POLYMER SCIENCE, Issue 6 2010
    Gökhan Erkan
    Abstract In this study an antifungal pharmaceutical agent, terbinafine, was microencapsulated by using in situ polymerization. The polymerization was carried out at four mole ratio level and preparations were applied to the 100% cotton fabric. X-ray diffractometry, DSC, FTIR, BET, contact angle measurements, particle size distribution and imaging techniques were performed. Best results were obtained in the case of 8 : 1 mole ratio. Strength of microcapsule applied fabrics to washing and fungus were also determined. After 25 washing cycle, microcapsules were still in the fabric and had antifungal properties against A. niger. Antifungal strength against T. rubrum was observed up to 15 washing cycles. © 2010 Wiley Periodicals, Inc. J Appl Polym Sci, 2010 [source]

    Effective treatment for dermatophytoses of the foot: effect on restoration of depressed cell-mediated immunity

    JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 8 2007
    M-H Schmid-Wendtner
    Abstract Superficial infections caused by dermatophyte fungi are highly prevalent throughout the world. Modern antimycotic agents like the azole itraconazole or the synthetic allylamine terbinafine greatly improved treatment outcomes in comparison with former therapeutic options with griseofulvin or older azole preparations like ketoconazole or fluconazole. In randomized trials involving patients with dermotophytoses, a great effectiveness has been shown especially for terbinafine. Oral terbinafine in general is well tolerated, has a low potential for drug interactions and, therefore, may be the most often used therapeutic agent for dermatophyte onychomycosis. However, there is a group of patients suffering from chronic dermatophytoses or early reinfections after antifungal therapy. For these patients, a depression of the delayed-type hypersensitivity reactivity was postulated. Just recently, effective antimycotic treatment, in particular with terbinafine, was shown to enhance and restore cell-mediated immunity, which potentially improves the therapeutic outcome even for this group of patients. [source]

    Pulse itraconazole vs. continuous terbinafine for the treatment of dermatophyte toenail onychomycosis in patients with diabetes mellitus

    JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 10 2006
    AK Gupta
    Abstract Background, Oral terbinafine and oral itraconazole are two of the most common agents used for the treatment of toenail dermatophyte onychomycosis. Despite the fact that diabetic patients are more likely to have onychomycosis than normal individuals are, there is little research into the efficacy of standard oral regimens of terbinafine and itraconazole for onychomycosis in the diabetic population. Study design, We present a prospective, randomized, single-blind, parallel group, comparator-controlled, multi-centre study designed to assess the efficacy of the pulse itraconazole (200 mg twice daily, 1 week on, 3 weeks off, for 12 weeks) vs. continuous terbinafine (250 mg once daily for 12 weeks) oral therapies in the treatment of dermatophyte toenail distal and lateral subungual onychomycosis (DLSO) in the diabetic population. Efficacy parameters, Primary efficacy measures included mycological cure rate (negative KOH and culture) and effective cure (mycological cure plus nail plate involvement of 10% or less) at Week 48. Results, At Week 48, mycological cure was attained by 88.2% (30 of 34) and 79.3% (23 of 29) of patients in the itraconazole and terbinafine groups, respectively (P not significant). Effective cure (mycological cure with , 10% of nail plate involvement) was attained by 52.9% (18 of 34) of the itraconazole group and 51.7% (15 of 29) of the terbinafine group (P not significant). Three itraconazole patients experienced side effects in the form of gastrointestinal problems. There were no serious adverse events and no interactions with concomitant medications recorded. Discussion, Both continuous terbinafine and itraconazole pulse therapy are effective and safe in the management of dermatophyte toenail onychomycosis in people with diabetes. [source]

    Effect of infection with Trichophyton mentagrophytes varietas interdigitale on phagocytosis in humans

    JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 2 2004
    T Gregurek-Novak
    ABSTRACT Background and aim, Phagocytosis by polymorphonuclear leucocytes (PMNLs) and macrophages is important in the defence of human organisms, especially in mycotic infections of the skin. The aim of this study was to examine the relationship between phagocytosis and a chronic type of infection with Trichophyton mentagrophytes varietas interdigitale (T. m. var. interdig.). Materials and methods, A group of 256 patients was investigated from 1990 to 2000. They were all treated with terbinafine. The parameters for phagocytosis were analysed by the Hersy method. Results, The immunological status of all of the patients was altered. Ingestion, digestion and random mobility decreased significantly (P < 0.001). Out of 256 patients treated with terbinafine, 196 (76%) were cured completely and the values for phagocytosis became normal. Conclusion, This investigation confirms the defect in the function of phagocytes of patients chronically infected by T. m. var. interdig. Terbinafine was shown to be an effective antimycotic drug, both fungicidal and immunostimulative. [source]

    Oral terbinafine in the treatment of onychomycosis: a comparison of continuous and extended-pause regimens

    JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2002
    A Shemer
    No abstract is available for this article. [source]

    Systemic photoallergy to terbinafine

    ALLERGY, Issue 8 2010
    R. Spiewak
    No abstract is available for this article. [source]

    Treatment of dermatophyte onychomycosis with three pulses of terbinafine (500 mg day,1 for a week)

    MYCOSES, Issue 1 2009
    Y. Takahata
    Summary We assessed the safety and efficacy of pulse therapy with terbinafine tablets in 55 patients with dermatophytic onychomycosis. One pulse consisted of oral terbinafine tablets (500 mg day,1) given for 1 week usually followed by a 3-week interval. This regimen was repeated twice. Topical 1% terbinafine cream was applied daily. Efficacy was assessed based on both clinical and mycological examinations 1 year after treatment initiation. We observed a complete cure in 41 patients (74.5%), marked improved in three patients (5.6%), slight improvement in three patients (5.6%) and drop out in six patients (10.7%). Two patients (3.6%) discontinued terbinafine because of gastrointestinal disturbance (one patient) and drug-induced eruption (one patient). No patient had abnormal laboratory findings, including liver function tests. In summary, a regimen of three pulses of terbinafine therapy given daily for 1 week in combination with topical application of terbinafine cream appears to be safe and effective in treating dermatophytic onychomycosis and offers advantages in convenience and cost-effectiveness compared with continuous dosing. [source]

    Novel, single-dose, topical treatment of tinea pedis using terbinafine: results of a dose-finding clinical trial

    MYCOSES, Issue 1 2008
    Martine Feuilhade De Chauvin
    Summary Tinea pedis is the most common dermatophytosis requiring topical antifungals for at least 1,4 weeks. To determine the effectiveness of a novel topical single dose formulation of terbinafine (film forming solution-FFS) in the treatment of tinea pedis, 344 outpatients from 43 dermatological centres in France and Bulgaria suffering from tinea pedis with possible extension to soles confirmed by mycological examination (direct and culture) were evaluated for efficacy of terbinafine 1%, 5%, 10% FFS in a randomised double blind vehicle controlled parallel group dose finding study. Evaluations were carried out at baseline, 1 and 6 weeks after a single application of FFS. Effective treatment rate based on negative mycology (direct and culture) and minimal signs and symptoms (two or less with only mild recorded) was measured at week 6. Effective treatment rates at week 6 with terbinafine 1%, 5% and 10% FFS were 66%, 70%, 61% compared with 18% with placebo. All three active preparations were shown to be significantly superior to placebo (P < 0.001). Terbinafine 1% and 5% FFS were shown to be non-inferior to terbinafine 10% FFS. Terbinafine 1% FFS is an effective, safe dose for the treatment of tinea pedis. This novel product represents a significant advance with the enhanced compliance and convenience that it offers. [source]

    Usefulness and pharmacokinetic study of oral terbinafine for hyperkeratotic type tinea pedis

    MYCOSES, Issue 1 2008
    Izumi Kikuchi
    Summary To study and establish an optimal administration method of oral antifungal, terbinafine (TBF), for hyperkeratotic type tinea pedis, from the pharmacokinetic point of view, 20 patients with hyperkeratotic type tinea pedis were given TBF 125 mg once daily for 4 weeks and observed over time for improvement in dermatological symptoms and mycological efficacy. Targeting five of the patients, TBF concentration in the stratum corneum was measured using the liquid chromatography/tandem mass spectrometry (LC-MS/MS) method. TBF was detected in the stratum corneum of the sole 1 week after beginning the treatment in some cases and reached its peak 1 week after the completion of the treatment with a concentration of 247.8 ng g,1, which was approximately more than 50 times higher than its minimal inhibitory concentration against dermatophytes. TBF was not detected at 8 weeks post-treatment, although its concentration was 50.73 ng g,1 at 6 weeks post-treatment. Its effectiveness rate (effective + markedly effective) was 95% (19/20) with no adverse reactions, including abnormal changes in the laboratory test values, in any patient. These results suggest that TBF is a useful drug to treat hyperkeratotic tinea pedis from the pharmacokinetic point of view. [source]

    Agar sublimation test for the in vitro determination of the antifungal activity of morpholine derivatives

    MYCOSES, Issue 5-6 2004
    A. Polak
    Antimykotische Aktivität; Morpholine; Sublimation Summary We studied the in vitro antifungal activities of a wide range of antimycotic agents, including amorolfine, terbinafine, naftifine, five morpholine derivatives, ciclopiroxolamine, bifonazole, clotrimazole, ketoconazole, itraconazole, fluconazole, voriconazole, flucytosine, amphotericin B, nystatin, and caspofungin, against Candida albicans and Trichophyton rubrum by conventional agar diffusion tests and by a novel sublimation method. For the sublimation method, 6 mm filter paper disks were soaked with defined amounts of antimycotic drugs, air dried, placed in the center of the lids of 9 cm Petri dishes, and incubated upside down with inoculated agar plates 10 mm above the disks. The conventional disk diffusion tests produced inhibition zones as previously described. The disk sublimation tests produced large inhibition zones with amorolfine, five amorolfine derivatives, and terbinafine, but with none of the other antifungal agents. Possible therapeutic advantages of agents, which are able to overcome air cavities in mycotic lesions, e.g. in onychomycosis, are discussed. Zusammenfassung Wir untersuchten in vitro die antimykotische Aktivität eines breiten Spektrums von Antimykotika, einschließlich Amorolfin, Terbinafin, Naftifin, fünf Morpholin-Derivaten, Ciclopiroxolamin, Bifonazol, Clotrimazol, Ketoconazol, Itraconazol, Fluconazol, Voriconazol, 5-Fluorcytosin, Amphotericin B, Nystatin und Caspofungin, gegenüber Candida albicans und Trichophyton rubrum mit konventionellen Agardiffusionstesten und mit einer neuartigen Sublimationsmethode. Für die Sublimationsmethode wurden 6 mm-Filterpapier-Blättchen mit definierten Mengen von Antimykotika getränkt, luftgetrocknet, in die Mitte der Deckel von 9 cm-Petrischalen gelegt und mit der inokulierten Agarplatte 10 mm über den Blättchen umgedreht inkubiert. Die konventionellen Agardiffusionsteste produzierten Hemmhöfe wie früher beschrieben. Die Blättchen-Sublimationsteste produzierten große Hemmhöfe mit Amorolfin, fünf Morpholin-Derivaten und Terbinafin, nicht jedoch mit den anderen Antimykotika. Mögliche therapeutische Vorteile von Agentien, die luftgefüllte Hohlräume in mykotischen Läsionen überbrücken können, z. B. im Nagel bei Onychomykose, werden diskutiert. [source]

    Guidelines for the Management of Tinea Capitis in Children

    PEDIATRIC DERMATOLOGY, Issue 3 2010
    Talia Kakourou M.D.
    Tinea capitis always requires systemic treatment because topical antifungal agents do not penetrate the hair follicle. Topical treatment is only used as adjuvant therapy to systemic antifungals. The newer oral antifungal agents including terbinafine, itraconazole, and fluconazole appear to have efficacy rates and potential adverse effects similar to those of griseofulvin in children with TC caused by Trichophyton species, while requiring a much shorter duration of treatment. They may be, however, more expensive (Grading of recommendation A; strength of evidence 1a). Griseofulvin is still the treatment of choice for cases caused by Microsporum species. Its efficacy is superior to that of terbinafine (Grading of recommendation A; strength of evidence 1b), and although its efficacy and treatment duration is matched by fluconazole (Grading of recommendation A; strength of evidence 1b) and itraconazole (Grading of recommendation A; strength of evidence 1b), griseofulvin is cheaper. It must be noted, however, that griseofulvin is nowadays not available in certain European countries (e.g., Belgium, Greece, Portugal, and Turkey). [source]

    Reliability of self-reported willingness-to-pay and annual income in patients treated for toenail onychomycosis

    BRITISH JOURNAL OF DERMATOLOGY, Issue 5 2007
    P.M.H. Cham
    Summary Background, Willingness-to-pay (WTP) is a health economics measure that has recently been used for skin diseases to evaluate patients' quality of life. However, the reliability of this measure has not been investigated in the dermatology literature and is essential in validating its use in health services research. Objectives, This study evaluated the test-retest reliability of self-reported annual income and WTP, a health economics measure of disease impact, in patients with toenail onychomycosis. Methods, Forty-six patients enrolled in a randomized clinical trial comparing two different dosing regimens of terbinafine completed a self-administered questionnaire at baseline and 1 month later. The questionnaire asked: (i) how much patients would be willing to pay for a theoretical treatment with a cure rate of 85% for their current onychomycosis (10 categories: $0,50, $51,100, to > $800); and (ii) annual income (10 categories: $0,10 000 to > $200 000). Results, Forty-four patients reported WTP at both visits, and 55% reported the same WTP. The quadratic-weighted (Fleiss,Cohen) , statistic indicated moderate agreement (, = 0·50, 95% confidence interval, CI 0·24,0·75, P < 0·01) as did the Spearman rank-order correlation coefficient (rs = 0·57, P < 0·01; median difference = 0, P = 0·50). Strong agreement was shown among the 42 patients who reported income at both visits; 71% reported the same annual income category (, = 0·72, 95% CI 0·47,0·96, P < 0·01; rs = 0·68, P < 0·01; median difference = 0, P = 0·77). Age, disease severity and duration, previous therapy, self-reported annual income, and medication side-effects were not statistically associated with the reliability of WTP. Conclusions, WTP and annual income demonstrated moderate and strong test-retest reliability, respectively. Self-reported WTP can serve as a reliable measure for future health economics research on onychomycosis. [source]

    Cumulative meta-analysis of systemic antifungal agents for the treatment of onychomycosis

    BRITISH JOURNAL OF DERMATOLOGY, Issue 3 2004
    A.K. Gupta
    Summary Background Onychomycosis is a common nail disease that is often chronic, difficult to eradicate, and has a tendency to recur. The most common oral therapies for dermatophyte toenail onychomycosis include terbinafine, itraconazole and fluconazole. Objectives A cumulative meta-analysis of the randomized controlled trials (RCTs) for antimycotic agents was performed to determine whether the pooled estimate of the cure rates has remained consistent over the years. Furthermore, for each agent we compared the overall meta-analytical average of both mycological and clinical response rates of RCTs vs. open studies. Methods We searched MEDLINE (1966 to November 2002) for relevant studies evaluating the efficacy of the oral antifungal agents terbinafine, itraconazole (pulse or continuous), fluconazole and griseofulvin for treating dermatophyte toenail onychomycosis. Studies included in this meta-analysis required a standard accepted dosage regimen, treatment duration and follow-up period. To determine the cumulative meta-analytical average, studies were sequentially pooled by adding one study at a time according to the date of publication (i.e. earliest to the most recent). Results There were 36 studies included in the analyses. For RCTs the change in efficacy of mycological cure rates from the first trial to the overall cumulative meta-average for each drug comparator is as follows (with 95% confidence interval): terbinafine, 78 ± 6% (n = 2 studies, 79 patients) to 76 ± 3% (n = 18 studies, 993 patients) (P = 0·68); itraconazole pulse, 75 ± 10% (n = 1 study, 20 patients) to 63 ± 7% (n = 6 studies, 318 patients) (P = 0·25); itraconazole continuous, 63 ± 5% (n = 1 study, 84 patients) to 59 ± 5% (n = 7 studies, 1131 patients) (P = 0·47); fluconazole, 53 ± 6% (n = 1 study, 72 patients) to 48 ± 5% (n = 3 studies, 131 patients) (P = 0·50); and griseofulvin, 55 ± 8% (n = 2 studies, 109 patients) to 60 ± 6% (n = 3 studies, 167 patients) (P = 0·41). The cumulative meta-analytical average of mycological cure rates when comparing RCTs vs. open studies was: terbinafine, 76 ± 3% (n = 18 studies, 993 patients) vs. 83 ± 12% (n = 2 studies, 391 patients) (P = 0·0028); itraconazole pulse, 63 ± 7% (n = 6 studies, 318 patients) vs. 84 ± 9% (n = 3 studies, 194 patients) (P = 0·0001); and fluconazole, 48 ± 5% (n = 3 studies, 131 patients) vs. 79 ± 3% (n = 3 studies, 208 patients) (P = 0·0001). Conclusions The cumulative meta-analysis of cure rates for RCTs suggests that over time, as new RCTs have been conducted, the efficacy rates have remained consistent. The efficacy rates of open studies are substantially higher compared with RCTs and may therefore overestimate cure rates. [source]

    Isolated thrombocytopenia associated with oral terbinafine

    BRITISH JOURNAL OF DERMATOLOGY, Issue 3 2002
    H-H. Tsai
    No abstract is available for this article. [source]

    In vitro susceptibility of the seven Malassezia species to ketoconazole, voriconazole, itraconazole and terbinafine

    BRITISH JOURNAL OF DERMATOLOGY, Issue 4 2000
    A.K. Gupta
    Fifty-five strains, either authentic or ex-type, of seven Malassezia species were investigated for in vitro susceptibility to various concentrations (0·03,64·0 µg/mL) of three azole drugs, ketoconazole, voriconazole and itraconazole, as well as the allylamine terbinafine, using the agar dilution method. All strains of the seven Malassezia species were susceptible to the three azole drugs at low concentrations. M. furfur, M. sympodialis, M. slooffiae, M. pachydermatis, M. globosa, M. obtusa and M. restricta were most sensitive to ketoconazole and itraconazole, with minimum inhibitory concentrations (MICs) ranging from , 0·03 to 0·125 ,g/mL. The recently introduced antifungal, voriconazole, was also very effective, with MIC80 values , 0·03 ,g/mL for 80% of strains. MICs of terbinafine against the seven Malassezia species ranged from , 0·03 to 64·0 ,g/mL. There were variations in susceptibility of the seven Malassezia species to ketoconazole, voriconazole, itraconazole and terbinafine. Strains of M. furfur, M. globosa and M. obtusa were more tolerant to terbinafine than the remaining Malassezia species; M. sympodialis was highly susceptible. M. furfur strains tested with terbinafine ranged from highly susceptible to relatively resistant. Correct identification of Malassezia species could facilitate selection of appropriate antifungal therapy. [source]

    Subacute cutaneous lupus erythematosus associated with terbinafine

    CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 7 2009
    M. Kasperkiewicz
    No abstract is available for this article. [source]