Combination of oral terbinafine and topical ciclopirox compared to oral terbinafine for the treatment of onychomycosis.

BACKGROUND

Treatment of onychomycosis has recently been enhanced by the introduction of combination therapies.

OBJECTIVE

To evaluate the efficacy of a combination therapy of ciclopirox nail lacquer and oral terbinafine compared to oral terbinafine monotherapy for the treatment of onychomycosis caused by dermatophytes.

PATIENTS AND

METHODS

Eighty patients with onychomycosis were randomly assigned to receive either oral terbinafine 250 mg/day for 16 weeks or a combination of oral terbinafine 250 mg/day for 16 weeks and topical ciclopirox nail lacquer once daily for 9 months. Both groups were followed up for 9 months from start of treatment.

RESULTS

After 9 months of treatment, the mycological cure rates were 22/34 (64.7%) for the terbinafine-only group and 30/34 (88.2%) for the combination therapy group (p<0.05). No significant difference was noted in the complete cure rate.

CONCLUSION

Combination therapy of oral terbinafine and ciclopirox nail lacquer is a safe and more effective treatment for onychomycosis than terbinafine alone, especially in younger patients and in shorter-duration onychomycosis.