WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Shamil Al-Jebori* and Haitham B. Fathi

ABSTRACT

Background: In the era of exponential increase in recalcitrant dermatophytoses, short course monotherapy is no more sufficient to eradicate the fungus and prevent its relapse. The aim of the study: To evaluate the effectiveness of long-term use of combined oral itraconazole and terbinafine in the treatment of chronic and recurrent tinea corporis et cruris. Patients and methods: From January to June, 2023, 50 patients with chronic or recurrent tinea corporis et cruris participate in this open-labeled randomized trial. Patients assigned to either monotherapy terbinafine group or combined therapy group (Itraconazole and terbinafine) administered daily for 8 weeks. The patient with partial cure was provided by another eight weeks therapy. The patients were assessed using clinic symptom & clinical outcome scores. Results: 84 patients with chronic tinea corporis et cruris participate in the current open trial. 45 patients used combined therapy of itraconazole and terbenafine while 39 patients treated by terbenafine alone for 16 weeks. The duration of dermatophytosis in the studied sample was 10.15 ± 2.85 months and the extent of BSA involved was 6.12 ± 2.19 %. At the end of 16 weeks, persistence of pruritus was significantly higher in monotherapy group (17.9% Vs. 2.2%). The erythema vanish almost completely in combination therapy group (95.6%) compared to 74.4% in monotherapy group (p=0.02). Active border persist only in monotherapy group in 10.3% of patients. All patients treated by combined therapy were cured, while 31 (79.5%) of monotherapy were cured, 6 (15.4%) classified as partially cured and 2 (5.1%) failed to response. Conclusion: A long-term of Combination therapy of itraconazole and terbinafine is superior to monotherapy of tebenafine alone. It is strongly advised to reevaluate the appropriate antifungal dosage for combination therapy in the future.