Evaluation of efficacy and safety of oral voriconazole in the management of recalcitrant and recurrent dermatophytosis
Chandrashekar B.S., Poojitha D.S.
Abstract
BACKGROUND: Dermatophytosis is a worldwide public health problem, affecting > 25% of the world's population. There has been a rampant increase in the resistant, recurrent dermatophytosis in the past few years, especially in India. Azole resistance in dermatophytes has been reported to be as high as 19% worldwide, hence evaluating the efficacy and safety of a newer oral antifungal is important. AIM: To evaluate the efficacy and safety of oral voriconazole in the management of recalcitrant and recurrent dermatophytosis. METHODS: Patients with extensive, recurring and resistant dermatophytosis. The clinical diagnosis was confirmed by potassium hydroxide staining. Patients were given a 2-week course of oral voriconazole, administered as 800 mg on Day 1, followed by two daily doses of 200 mg (total 400 mg/day) for the remaining 13 days. The patients were followed up in Week 2 to assess response and in Week 6 to assess recurrence. Patients were monitored for any adverse effects (AEs). RESULTS: In total, 40 patients completed the study. Complete clearance was seen in 90% and 75% at Weeks 2 and 6, respectively. By the end of Week 6, eight patients (20%) had partial improvement of disease without complete clearance and only 5% had recurrence. No AEs were recorded during the treatment course. CONCLUSION: Voriconazole, a novel oral antifungal that can be used for treatment of recurrent and resistant dermatophytosis, has a good efficacy and safety profile with a very low rate of recurrence.