A comparison of terbinafine (Lamisil) 1% cream given for one week with clotrimazole (Canesten) 1% cream given for four weeks, in the treatment of tinea pedis.

Terbinafine (Lamisil) is a synthetic allylamine antifungal which has been shown to be fungicidal against dermatophytes and a number of yeasts and moulds. Topical application of terbinafine 1% cream has been shown to be a highly effective short-duration therapy for dermatophytosis of the skin. The aim of this multicentre, double-blind, parallel-group study was to compare the safety and efficacy of terbinafine 1% cream, applied twice daily for 1 week, with clotrimazole (Canesten) 1% cream, applied twice daily for 4 weeks, in the treatment of tinea pedis. One hundred and seven patients with mycologically proven tinea pedis received 1 week of terbinafine 1% cream, followed by 3 weeks of placebo, and 104 patients received clotrimazole 1% cream for 4 weeks. Mycological cure (negative microscopy and culture) and effective treatment (mycological cure with no or minimal signs and symptoms) were assessed 4 and 6 weeks after commencing therapy. Mycological cure rates were 93.5% for terbinafine and 73.1% for clotrimazole (P = 0.0001) at 4 weeks. Effective treatment rates at 4 weeks were 89.7% for terbinafine and 58.7% for clotrimazole (P = 0.0001), and 89.7% for terbinafine and 73.1% for clotrimazole (P = 0.002) at 6 weeks. The results show that 1 week of terbinafine b.d. is more effective than 4 weeks of clotrimazole b.d., in terms of both mycological cure and effective treatment.