Publication:

Comparative study of terbinafine or itraconazole monotherapy versus combined therapy in dermatophytosis

Background Dermatophytosis, is a very frequent fungal infection of skin prevailing in underprivileged countries. As drug resistance of monotherapy is rising rapidly, combination therapy is blooming as the preferred choice. Itraconazole and terbinafine are widely used antifungal drugs in Bangladesh. Although many studies on monotherapy of these drugs have been done for the treatment of fungal infections, but study on their combined use showing difference with cure rates and recurrence rates in our country is still inadequate. Objectives were to determine and compare the clinical outcome of monotherapy with terbinafine or itraconazole comparing with combined therapy in various dermatophytosis (tinea infections).

Methods Clinically diagnosed patients suffered from various tinea infections at multiple private clinics in Gazipur district of Bangladesh were treated from January to June 2024. Total 150 patients were divided into three groups (Itraconazole only, terbinafine only and combination of both). The therapeutic effects were evaluated by clinical cure rate by clinical symptoms, mycological cure rate by mycology examination, adverse effects, and recurrence rates of disease.

Results The data of patients were evaluated biweekly period and at 4 and at end of 8 weeks of therapy. In the combined group, the symptoms were significantly cured, in comparison to the terbinafine or itraconazole group (p1<0.05 and p2<0.05). The clinical cure rate, mycological cure rate, recurrence rate showed 92%, 90% and 4% in combined group, 78%, 74% and 14% in terbinafine group, 74%, 70% and 18% in Itraconazole group respectively. The combination therapy achieved better results. Adverse effects were less in each group during follow-up. The 96% patients was satisfied with combined treatment.

Conclusions Combination therapy is more efficacious than monotherapy for treatment of tinea infections and demonstrates more successful strategy for treating resistant dermatophytosis.