EFFICACY AND SAFETY OF TERBINAFINE (LAMISIL) IN DERMATOPHYTE ONYCHOMYCOSES - A 50 CASE-STUDY

Terbinafine is an antifungal agent of the allylamine class, which is fungicidal when administered per os. Because of its pharmacokinetic properties, terbinafine proved successful in onychomycoses. The purpose of this study was the evaluation of terbinafine efficacy and tolerance in dermatophyte onychomycoses, in a monocenter open study. Fifty patients have been treated with 250 mg terbinafine daily. Feet were involved in 43 cases, hands and feet in 6 cas, and hand alone in 1 case. Trichophyton rubrum has been isolated in 46 malades, and Trichophyton mentagrophytes in 4 patients. The severity of onychomycoses has been evaluated as follows: involvement of the first toenail (44 cases), total involvement of the nail plate (38 cases), ineffective or non tolerated previous antifungal treatments (37 cases), chronic evolution (mean duration 6.5 years), multiple nails involved (average 6). The mean duration of treatment was 22.2 weeks (range 4 to 8 months). Mycological cure rate was 92 p. 100, and complete cure rate was 86 p. 100. The mean time to mycological cure was 22.4 weeks and the mean time to complete cure was 31.5 weeks. Tolerance was good: minor side effects were noted in 3 patients, and 1 developed reversible agueusia; a moderate elevation of ALAT and ASAT occurred in 1 case. Other drugs were simultaneously administered in 15 patients: no side effects due to drug interactions have been observed. Terbinafine proved highly successfull and well tolerated even in those onychomycoses which were difficult totreat. High cure rates were obtained with an average of 5 month-treatment.