Efficacy of Terbinafine 1% cream versus clotrimazole 1% cream in the treatment of pityriasis versicolor

ABSTRACT

Terbinafine a member of allylamines group is a new class of antimycotic agents that blocks sterol biosynthesis in the fungi through inhibition of sequalene epoxidase and with consequent sequalene accumulation due to a primarily fungicidal process. Terbinafine is very effective on various fungi as an oral and topical antifungal agent. The aim of this study was to compare the antifungal efficacy of terbinafine 1% cream with clotrimazole 1% in patients with pityriasis versicolor. This clinical trial study was performed on 50 patients [30 males and 20 females] with mean age of 20 years [aged between 15-55 years] who randomly treated with terbinafine and clotrimazole for 4 weeks. The efficacy of drug and improving process evaluated mycologically and clinically before starting the study and at the end of each week. A patient was considered mycologically cured when direct microscopy was negative and clinically cured when all clinical parameters were considered negative. Negativizations of all clinical parameters were observed within 2 weeks in 60% of terbinafine and 35% clotrimazole recipients. At the end of four weeks, disappearance of lesions were seen in 90% and 80%, respectively [p<0.05]. The percentage of negativization of direct microscopy in terbinafine group was 1.4 fold higher than that clotrimazole group after 2 weeks of treatment. At the end of therapy, 95% of terbinafine and 90% of clotrimazole treated subjects were clinically cured [p>0.05]. Both drug eruptions and intolerance in two treated groups were similar. Although the efficacy of the both drugs is similar, but considering the expense of therapy, clotrimazole is preferred regimen for therapy of tinea versicolor