Comparison of Efficacy of Double Dose Oral Terbinafine versus Itraconazole in the Treatment of Dermatophyte Infections of Skin

Objective: To compare the efficacy of double-dose oral Terbinafine and Itraconazole in treating dermatophytic infections. Study Design: Randomized controlled trial (ClinicalTrials.gov: NCT04880980). Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Mar 2021 to Mar 2022. Methodology: One hundred and twenty patients with dermatophyte infections of the skin (i.e., tinea corporis and cruris) diagnosed by clinical presentation and KOH mount were included in this study. After randomization, patients were divided into two groups. Group-A was managed with double-dose oral Terbinafine, while Group-B was managed with double-dose oral Itraconazole. Clinical response and side effects were seen and recorded initially at two weeks and then at four weeks.Efficacy and adverse effects were compared in both groups at the end of four weeks. Results: Out of 120 patients with dermatophyte infections of the skin included in the study, 59(49.2%) took double-dose oral Terbinafine while 61(50.8%) took double-dose oral Itraconazole after randomization. It was revealed that Itraconazole was more efficacious in achieving cure at the end of 4-weeks as compared to double dose Terbinafine (p-value=0.001), while adverse effects studied were not statistically significant or different in both the groups (p-value>0.005). Conclusion: This randomized controlled trial showed that double dose oral Itraconazole was more efficacious in treating dermatophyte infections of the skin (i.e., Tinea corporis and cruris) compared to double dose oral Terbinafine. Adverse effects were minimal in both groups and were not specially related to any of these medications.