Intermittent therapy with terbinafine and nail abrasion for dermatophyte toe onychomycosis: a pilot study

Onychomycosis constitutes up to 50% of all nail disorders. Toenails are generally affected, mostly due to dermatophytes. Terbinafine is the most potent antifungal agent in vitro against dermatophytes. There are few randomised controlled trials using a non-continuous dose of terbinafine. The aim of this open-label pilot study was to reduce the total drug amount, the collateral effects and, specially, the costs; albeit maintaining the same efficacy of the standard regimens. Compare the outcomes of two different intermittent regimens with the same total amount of the medication (42 tablets in 6months). Forty-one patients were divided into the following groups: terbinafine 250mgday1, for 7days, monthly or terbinafine 500mgday1, once daily, for 7days, every 2months, both plus nail abrasion during 6months. The efficacy was evaluated at months 6, 12 and 18 using the disease free nail criteria. Total cure=group I: eight patients (44.4%) and group II: eight patients (44.4%). Partial cure=group I: five patients (27.8%) and group II: four patients (22.2%). Treatment failure=group I: five patients (27.8%) and group II: three patients (16.7%). Recurrence=group I: zero patients (0.0%) and group II: three patients (16.7%). Two intermittent dosing regimens of terbinafine plus nail abrasion proved to be an alternative statistically effective, safe and with reduced drug costs for dermatophytes toenail onychomycosis.