The science and rationale of arriving at the correct drug & dosimetry of griseofulvin, fluconazole, terbinafine, and itraconazole in superficial dermatophyte infections: an important step before a pragmatic trial.

The science and rationale of arriving at the correct drug & dosimetry of griseofulvin, fluconazole, terbinafine, and itraconazole in superficial dermatophyte infections: an important step before a pragmatic trial. Br J Dermatol. 2020 Sep 21;: Authors: Sardana K, Mathachan SR Abstract While India faces the issue of recalcitrant dermatophytosis1 , we would like to focus on the scientific rationale of drug dosimetry based on background microbiological data & existential serum/skin level data (Figure 1) that should predate a clinical trial2 . The first step is based on the minimum inhibitory concentration (MIC) data and antifungal susceptibility testing (AFST).1 The studies from India1,3-4 with MIC data have documented resistance to terbinafine (TER) and increased MIC to griseofulvin & fluconazole, which predicts their disappointing results.2 This should be followed by an assessment of minimal fungicidal concentration (MFC) that determines the fungicidal or fungistatic properties of the drug. In India, the clinical failure, made clinicians prescribe combinations of drugs,1 which is alarming and should be based on checkerboard studies and fractional inhibitory concentration data (FICs). PMID: 32955729 [PubMed - as supplied by publisher]
Source: The British Journal of Dermatology - Category: Dermatology Authors: Tags: Br J Dermatol Source Type: research