Evy Ervianti
Departement Of Dermatology And Venereology, Faculty Of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Universitas Airlangga Teaching Hospital, Surabaya

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Journal : Indonesian Journal of Tropical and Infectious Disease

COMBINATION ANTIFUNGAL THERAPY FOR ONYCHOMYCOSIS Nur Khamidah; Evy Ervianti
Indonesian Journal of Tropical and Infectious Disease Vol. 7 No. 1 (2018)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (212.229 KB) | DOI: 10.20473/ijtid.v7i1.6235

Abstract

Onychomycosis is a fungal infection of the nail unit including the nail matrix, the nail bed and the nail plate by both dermatophyte and non-dermatophyte agents. It is disturbs not only cosmetic disfigurement, but also it may have an impact on patients’ emotional, social and occupational functioning, finally affecting the overall quality of life. The incidence rate tends to increase, management of onychomycosis is still challenging. Important problems regarding antifungal monotherapy have experienced many failures and recurrences. In general, pharmacological approaches for onychomycosis can be topical or oral antifungal. Antifungal monotherapies often lead to failure treatment, also high incidence of recurrence. One strategy for this problem is a combination antifungal therapy. In vitro studies show the synergistic effect of using combination two antifungals (both oral antifungal or combination topical and oral antifungal), hence it is mycologically or clinically expected to increase the success rate of onychomycosis therapy. This review tries to evaluate the previous study exploring the effectiveness of antifungal combination therapies on onychomycosis. Two oral antifungals usually used are terbinafine as fungicidal agent and itraconazole as fungistatic agent. There is combination between topical and oral antifungal such as itraconazole or terbinafine with amorolfine or ciclopirox, also other combination like griseofulvin and amorolfone or tioconazole. All the combination therapies show better result than monotherapy alone, but it is still difficult to conclude whether antifungal combinations in onychomycosis will increase effectiveness due to variations in therapeutic duration, result definition, and statistical evaluation on existing studies. Further research is required with longer duration of observation, uniform patient criteria and definition of success, random control and blinding to minimize bias.
Co-Authors Addia Salsabila Ade Fernandes Ade Fernandes Afif Nurul Hidayati Afif Nurul Hidayati Alphania Rahniayu Amanda Gracia Manuputty Amira Suryani Rahmatika Anang Endaryanto Andre Yuindartanto Arthur Pohan Kawilarang Astindari Astindari Astindari Astindari Astindari Bagus Bagus Bagus Haryo Kusumaputra Bagus Haryo Kusumaputra Bagus Meurah Suropati Bernadya Yogatri Anjuwita Budi Utomo Budi Utomo Budi Utomo Budi Utomo Budi Utomo Budiono Budiono Chesia Christiani Liuwan Cindy Fransisca Cita Rosita Sigit Prakoeswa Citra Dwi Harningtyas Damayanti Damayanti Damayanti Damayanti Damayanti Damayanti Damayanti Damayanti Damayanti Damayanti Desiana Widityaning Sari Dewi Puspitorini Diah Mira Indramaya Diah Nugrahaeni Diah Nugrahaeni, Diah Dwi Murtiastutik Dwi Murtiastutik Dwi Nurwulan Pravitasari Dyatiara Devy Rahadiyanti Dyatiara Devy Rahadiyanti Eko Budi Koendhori, Eko Budi Ellenita Soebakti Endang Wahyu Fitriani Esthy Yuliana Esti Hendradi Farhat Surya Ningrat Fatma Rosida Hamidah Luthfidyaningrum Hans Lumintang Hans Lumintang, Hans I Gusti Ayu Agung Elis Indira I Gusti Nyoman Darmaputra Indah Purnamasari Indiarsa Arief L Indiarsa Arief L, Indiarsa Arief Indropo Agusni Indropo Agusni INDROPO AGUSNI Irmadita Citrashanty Irmadita Citrashanty Iskandar Zulkarnain Iskandar Zulkarnain Iskandar Zulkarnain Iskandar Zulkarnain Iskandar Zulkarnain Karina Dyahtantri Pratiwi Kurniati Kurniati Linda Astari Lunni Gayatri Lunni Gayatri, Lunni M. Yulianto Listiawan Made Putri Hendaria ManikRetno Wahyunitisari Maria Ulfa Sheilaadji Maria Ulfa Sheilaadji Marsudi Hutomo Maya Wardiana Maylita Sari Maylita Sari Maylita Sari Medhi Denisa Alinda Menul Ayu Umborowati Menul Ayu Umborowati Menul Ayu Umborowati Nadya Kelfinta Hanani Natalia Tanojo Nur Khamidah Nyoman Suryawati Pepy Dwi Endraswari Pepy Dwi Endraswari, Pepy Dwi Putri Intan Primasari Putri Intan Primasari Rahmadewi Rahmadewi Regitta Indira Agusni Retha Retha Riezky Januar Pramitha Sawitri Sawitri Sawitri Sawitri Sawitri Sawitri Sawitri Sawitri Selvia Yuliani Dwi Ratih Sanggarwati Septiana Widyantari Shakti Indraprasta Silvani Geani Sunarso Suyoso Sunarso Suyoso Sunarso Suyoso Sunarso Suyoso, Sunarso Sylvia Anggraeni Tjokorde Istri Nyndia Vaniari Trisniartami Setyaningrum Wisnu Triadi Nugroho Wisnu Triadi Nugroho Yoana Fransiska Wahyuning Christi Yuri Widia, Yuri Yuri Widya Yusuf Wibisono zahruddin ahmad