Oral Itraconazole and Terbinafine vs. Itraconazole as a Novel Regimen for the Newly Emergent Chronic Tinea: A Comparative Clinical Study

Dermatophytosis is the most common contagious fungal disease. Iraq, like the other many countries around the world, is facing an emergence of chronic, resistant and relapsing tinea infections. This study compared the efficacy, safety and the relapse rate of a combination therapeutic regimen of itraconazole and terbinafine vs. itraconazole alone in the treatment of chronic tinea infections. The research was conducted at the dermatology and venereology outpatient’s unit, Ramadi Teaching Hospital, Iraq, during the period from May 2022 to May 2023. Patients were divided equally into two groups. Group I received combination of itraconazole and terbinafine while group II was on itraconazole alone for eight weeks for each group. For assessment of relapse rate, follow-up was for two months. Only 148 out of 160 of enrolled patients completed the study. 98 (66.2 %) were males and 50 (33.8%) were females. The mean of the age (±SD) of the total was 33.04±12.65. There was no significant difference in their residency. Family history was positive in majority of patients 119 (80.4%). After two weeks, there was significant difference in response to treatment, where a marked clearance was achieved by 54 (73%) patients in group I, while only 17 (23%) patients in group II, (p value 0.00). After 8 weeks, complete clearance was 68 (92%) in group I, while 35 (47%) in group II (p value 0.00). Marked clearance was 6 (8%) in group I, while 33 (45%) in group II (p value 0.00). Relapse rate, after 16 weeks, was 5 (7%) in group I, while 42(57%) in group II (p value 0.00). We concluded that therapeutic regimen of itraconazole and terbinafine were effective, safe and well tolerated with low relapse rate.