Journal of cutaneous medicine and surgery · 2015
Toenail Onychomycosis-A Canadian Approach With a New Transungual Treatment: Development of a Clinical Pathway.
СтатьяСистематический обзорНазвание и аннотация: Перевод пока не подготовлен
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Gupta Aditya K, Sibbald R Gary, Andriessen Anneke, Belley Richard, Boroditsky Alan, Botros Mariam, Chelin Robert, Gulliver Wayne, Keast David, Raman Mani
Аннотация
BACKGROUND: Onychomycosis is a difficult-to-treat infection whose current treatment paradigm relies primarily on oral antifungals. The emergence of new topical drugs broadens the therapeutic options and prompts a re-evaluation of the current Canadian treatment strategy.
OBJECTIVE: To define a patient-centred Canadian treatment strategy for onychomycosis.
METHODS: An expert panel of doctors who treat onychomycosis was convened. A systematic review of the literature on treatments for onychomycosis was conducted. Based on the results, a survey was designed to determine a consensus treatment system.
RESULTS: First-line therapy should be selected based on nail plate involvement, with terbinafine for severe onychomycosis (>60% involvement), terbinafine or efinaconazole for moderate onychomycosis (20%-60% involvement), and efinaconazole for mild onychomycosis (<20% involvement). Comorbidities, patient preference and adherence, or nail thickness may result in the use of alternative oral or topical antifungals.
CONCLUSION: These guidelines allow healthcare providers and patients to make informed choices about preventing and treating onychomycosis.
OBJECTIVE: To define a patient-centred Canadian treatment strategy for onychomycosis.
METHODS: An expert panel of doctors who treat onychomycosis was convened. A systematic review of the literature on treatments for onychomycosis was conducted. Based on the results, a survey was designed to determine a consensus treatment system.
RESULTS: First-line therapy should be selected based on nail plate involvement, with terbinafine for severe onychomycosis (>60% involvement), terbinafine or efinaconazole for moderate onychomycosis (20%-60% involvement), and efinaconazole for mild onychomycosis (<20% involvement). Comorbidities, patient preference and adherence, or nail thickness may result in the use of alternative oral or topical antifungals.
CONCLUSION: These guidelines allow healthcare providers and patients to make informed choices about preventing and treating onychomycosis.