Takahata Y, Hiruma M, Shiraki Y, Tokuhisa Y, Sugita T, Muto M
Department of Dermatology and Allergology, Juntendo University Nerima Hospital, Nerima-ku, Tokyo, Japan.
Mycoses. 2009 Jan;52(1):72-6. doi: 10.1111/j.1439-0507.2008.01531.x. Epub 2008 Apr 26.
We assessed the safety and efficacy of pulse therapy with terbinafine tablets in 55 patients with dermatophytic onychomycosis. One pulse consisted of oral terbinafine tablets (500 mg day(-1)) given for 1 week usually followed by a 3-week interval. This regimen was repeated twice. Topical 1% terbinafine cream was applied daily. Efficacy was assessed based on both clinical and mycological examinations 1 year after treatment initiation. We observed a complete cure in 41 patients (74.5%), marked improved in three patients (5.6%), slight improvement in three patients (5.6%) and drop out in six patients (10.7%). Two patients (3.6%) discontinued terbinafine because of gastrointestinal disturbance (one patient) and drug-induced eruption (one patient). No patient had abnormal laboratory findings, including liver function tests. In summary, a regimen of three pulses of terbinafine therapy given daily for 1 week in combination with topical application of terbinafine cream appears to be safe and effective in treating dermatophytic onychomycosis and offers advantages in convenience and cost-effectiveness compared with continuous dosing.
我们评估了特比萘芬片脉冲疗法对55例皮肤癣菌性甲真菌病患者的安全性和有效性。一个脉冲疗程包括口服特比萘芬片（500毫克/天），服用1周，之后通常间隔3周。该疗程重复两次。每天外用1%特比萘芬乳膏。在开始治疗1年后，根据临床和真菌学检查评估疗效。我们观察到41例患者（74.5%）完全治愈，3例患者（5.6%）显著改善，3例患者（5.6%）轻微改善，6例患者（10.7%）退出研究。2例患者（3.6%）因胃肠道不适（1例）和药物性皮疹（1例）停用特比萘芬。没有患者出现包括肝功能检查在内的实验室检查异常。总之，特比萘芬治疗3个脉冲疗程，每日服用1周，并联合外用特比萘芬乳膏，在治疗皮肤癣菌性甲真菌病方面似乎是安全有效的，与持续给药相比，在便利性和成本效益方面具有优势。
