Inappropriate use of oral terbinafine in family practice.

OBJECTIVE

To review whether oral terbinafine, used for fungal nail infections, is prescribed appropriately by general practitioners.

METHOD: Cross-sectional survey of forty volunteer practices. Prescribing systems were searched to identify patients who had been prescribed a course of oral terbinafine during 1998. The clinical records of five such patients in each practice were examined for additional information regarding appropriate diagnostic tests.

RESULTS

Five hundred sixty-nine patients (0.25% of the population aged 12 and over) were reported to have received a course of oral terbinafine. Sixty-four percent had been treated empirically without any recorded diagnostic test.

CONCLUSION

Treatment of onychomycosis with terbinafine is commonly undertaken without diagnostic confirmation. This empirical treatment does not comply with locally recommended good practice.