Toenails mycosis - itraconazole or terbinafine? Literature review Grzybica paznokci - itrakonazol czy terbinafina? Przegl d pi miennictwa

Toeneils mycosis is a common medical problem with incidence from 2 to 8% in general population, increasing significantly in people over 60 years old. The most popular pathogens are dermathopytes, mainly Trichophyton rubrum and Trichophyton mentagrophytes. Systemic therapy, combined therapy (systemic and topical) and topical monotherapy, in case of minimal nail infection, are the most popular methods. Introduction of broad-spectrum agents like azole derivatives (itraconazole) and terbinafine improved toenails mycosis systemic therapy. According to the literature review, the efficacy and safety profile of itraconazole and terbinafine are comparable in case of dermatophytes infection. Itraconazole is more effective in infections caused by yeast-like fungi. Hence, in systemic therapy of toenails mycosis, only these two agents should be considered. Before beginning of the treatment we have to take account of the type of pathogen, general conditions of the patients and other drug intake.