The Compliance and Long-term Follow up of Onychomycosis Treatment / 대한의진균학회지

ABSTRACT

BACKGROUND: Modern antifungal drugs achieve high cure rates in onychomycosis of the toes, but little is known about the long-term evolution of the treated patients. OBJECTIVE: We evaluated the compliance and long-term follow up of onychomycosis after treating the 438 patients with one of the 3 drugs including itraconazole, terbinafine and fluconazole. METHODS: On the basis of the patients' charts, photographs and telephone visiting, we investigated the positivity of the diagnostic methods, compliance and long-term follow up results of the onychomycosis treated with one of the three drugs including itraconazole, terbinafine and fluconazole from January 1999 to August 2002 in the Department of Dermatology, St. Mary's hospital, the Catholic University of Korea, Seoul. RESULTS: 1. The positivity rates of the KOH smear, fungus culture and KONCPA test were 68% (283/418), 18% (65/354) and 89% (178/200), respectively. 2. The percentage of the patients who had completely finished the course of the treatment were 61% (191/315) in the itraconazole-treated, 43% (30/69) in the terbinafine-treated and 21% (3/14) in the fluconazole-treated. 3. Cure rates after 1 year of the treatment were 34% (56/167) in the itraconazole-treated, 29% (10/35) in the terbinafine-treated and 86% (6/7) in the fluconazole-treated. Cure rate after 2 years of the treatment were 33% (17/51) in the itraconazole-treated, 8% (1/12) in the terbinafine-treated. Cure rates after 3 years of the treatment were 29% (9/31) in the itraconazole-treated, 10% (1/10) in the terbinafine-treated. 4. Cure rates after more than 1 year of the treatment were 33% (82/249) in the itraconazole-treated, 21% (12/57) in the terbinafine-treated. 5. Cure rates of the completely treated groups were 36%, 37% and 40% after 1 year, 2 years and 3 years in the itraconazole-treated and 44%, 20% and 20% after 1 year, 2 years and 3 years in the terbinafine-treated. CONCLUSION: In the treatment of onychomycosis, compliance rate varied very much according to the duration or method of medication, but the cure rates are different after more than 2 years of follow up between the itraconazole-treated and the terbinafine-treated.