Assaf R R, Elewski B E
Center for Medical Mycology, University Hospital of Cleveland, Case Wastern Reserve University School of Medicine, OH, USA.
J Am Acad Dermatol. 1996 Aug;35(2 Pt 1):216-9. doi: 10.1016/s0190-9622(96)90327-8.
Therapeutic limitations of griseofulvin in treating onychomycosis have led to a search for alternative antimycotic agents. An optimal dosing regimen for fluconazole has yet to be defined.
Our purpose was to evaluate the intermittent use of fluconazole (either once-weekly or alternate-day dosing) without concurrent nail avulsion in patients with moderate to severe onychomycosis.
Eleven patients with mycologically confirmed onychomycosis of the toenails or fingernails (43 infected nails) were treated with intermittent fluconazole until clinical cure was obtained. Eight patients received fluconazole 300 mg once weekly, one patient received 200 mg once weekly, and two patients received 100 or 200 mg of fluconazole every other day. Eight patients also used an adjunctive topical antimycotic preparation.
All six patients with toenails involved (32 infected nails) were clinically cured after a mean treatment duration of 6 months, and all five patients with fingernails involved (11 infected nails) were cured after 3.7 months. There were no significant clinical or laboratory adverse events.
Intermittent fluconazole, taken once weekly or on alternate days, is a well-tolerated and efficacious method to treat onychomycosis.
灰黄霉素在治疗甲癣方面的治疗局限性促使人们寻找替代抗真菌药物。氟康唑的最佳给药方案尚未确定。
我们的目的是评估中度至重度甲癣患者间歇性使用氟康唑（每周一次或隔日给药）且不同时进行拔甲的疗效。
11例经真菌学确诊的趾甲或指甲甲癣患者（43个感染指甲）接受间歇性氟康唑治疗，直至获得临床治愈。8例患者每周接受一次300mg氟康唑治疗，1例患者每周接受一次200mg氟康唑治疗，2例患者隔日接受100或200mg氟康唑治疗。8例患者还使用了辅助性外用抗真菌制剂。
所有6例累及趾甲的患者（32个感染指甲）在平均治疗6个月后临床治愈，所有5例累及指甲的患者（11个感染指甲）在3.7个月后治愈。未出现明显的临床或实验室不良事件。
每周一次或隔日服用的间歇性氟康唑是一种耐受性良好且有效的甲癣治疗方法。
