Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Letters to the Editor - Letter in Response to Previously Published Articles
2019:85:1;83-84
doi: 10.4103/ijdvl.IJDVL_844_18
PMID: 30460930

End of the road for terbinafine? Think of compliance to treatment

Noureddine Litaiem1 , Manel Karray1 , Sabrine Bouhlel2 , Takwa Bacha1 , Faten Zeglaoui1
1 Department of Dermatology, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia
2 Department of Parasitology, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia

Correspondence Address:
Noureddine Litaiem
Department of Dermatology, Charles Nicolle Hospital, University of Tunis El Manar, Tunis
Tunisia
Published: 21-Nov-2018
How to cite this article:
Litaiem N, Karray M, Bouhlel S, Bacha T, Zeglaoui F. End of the road for terbinafine? Think of compliance to treatment. Indian J Dermatol Venereol Leprol 2019;85:83-84
Copyright: (C)2019 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

We read with interest the publication entitled “End of the road for terbinafine? Results of a pragmatic prospective cohort study of 500 patients.”[1] In this paper, 500 patients diagnosed with dermatophytic infections (tinea corporis, tinea cruris and tinea faciei) were enrolled and prescribed oral terbinafine. After 4 weeks, the cumulative cure rate was low (30%) and the authors concluded that terbinafine is losing its efficacy.

The study conducted by Singh and Shukla[1] is interesting because terbinafine has been considered for a long time as the treatment of choice for dermatophytic infections with high efficacy and tolerability.[2],[3] The authors describe their study as being a pragmatic trial. Neither compliance to treatment nor in vitro assessment of antifungal resistance was analyzed.

We noticed similar low cure rates in Tunisia, concerning especially onychomycosis treated with terbinafine, and we performed a study trying to assess the reasons of treatment failure.

We conducted a prospective, descriptive and analytical study, enrolling all patients with mycologically proven hand and nail onychomycosis, between April 2016 and July 2017. Patients were treated according to the British guidelines.[3] Onychomycosis related to dermatophytic fungi was confirmed in 184 patients and terbinafine was prescribed to 66.3% of them. Only 24, 3% of the patients, responded to treatment after 6 months.

In our study, when patients were interviewed about compliance to treatment, 30% of them revealed that they did not take any pill and 21% of them said they only received a treatment for <4 months. The leading reasons of poor therapeutic compliance were the excessive cost of the drug (55%), and the fear of related side effects (36.23%).

Therefore, more studies should be carried out to evaluate compliance to terbinafine and in vitro antifungal resistance before drawing the conclusion about the “end of the road for terbinafine.”[4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References
1.
Singh S, Shukla P. End of the road for terbinafine? Results of a pragmatic prospective cohort study of 500 patients. Indian J Dermatol Venereol Leprol 2018;84:554-7.
[Google Scholar]
2.
Sahoo AK, Mahajan R. Management of tinea corporis, tinea cruris, and tinea pedis: A comprehensive review. Indian Dermatol Online J 2016;7:77-86.
[Google Scholar]
3.
Ameen M, Lear JT, Madan V, Mohd Mustapa MF, Richardson M. British Association of Dermatologists' Guidelines for the management of onychomycosis 2014. Br J Dermatol 2014;171:937-58.
[Google Scholar]
4.
Bhattacharjee R, Dogra S. ‘End of the road for terbinafine’ in dermatophytosis: Is it a valid conclusion? Indian J Dermatol Venereol Leprol 2018;84(6):706-7.
[Google Scholar]

Fulltext Views
435

PDF downloads
458
Show Sections