Terbinafine vs griseofulvin in the treatment of onychomycosis due to dermatophytes

Griseofulvin has been for a long time the only available antifungal agent for the systemic therapy of onychomycosis. However, this drug requires long treatment yielding low success rates and frequent relapses combined with a relatively high incidence of side effects. recently terbinafine, a new antifungal agent which has been shown to be an effective treatment with short-term regimen for onychomycosis, has been introduced in Italy. In a comparative double-blind study the efficacy of terbinafine and griseofulvin in the treatment of onychomycosis bas been evaluated. Out of 9 patients affected by fingernail onychomycosis, 4 were treated with terbinafine at the dosage of 250 mg/day for 2 months and 5 with griseofulvin at the dosage of 1 g/day for 4 months. Of 29 patients affected by toenail onychomycosis, 14 were treated with terbinafine 250 mg/day for 4 months and 15 with griseofulvin 1 g/day for 9 months. In all cases follow-up was 6 months. All four patients with fingernail onychomycosis (100%) and 11 of the 14 patients with toenail onychomycosis (78.5%) treated with terbinafine were completely cured. Two patients with fingernail onychomycosis (40%) and 4 patients with toenail onychomycosis (26.5%) treated with griseofulvin were cured. The successful results obtained with terbinafine, with the absence of concomitant relapses or side effects, suggest this drug as an agent of choice in the treatment of onychomycosis.