A Comparative Evaluation of the Efficacy of Oral Terbinafine versus Itraconazole in the Treatment of Dermatophytosis

Background: Dermatophytic infections, often worsened by hot and humid climates, are common fungal infections. Terbinafine and itraconazole are widely used oral antifungal agents to treat these conditions. However, increasing resistance to these drugs at conventional doses and durations has been observed. Consequently, this study was designed to compare the efficacy of terbinafine and itraconazole when administered in treating tinea corporis and tinea cruris. Methods: A randomized, prospective comparative study was conducted, involving 80 newly diagnosed patients with tinea corporis and tinea cruris, aged 18 years and above. The clinical diagnosis was confirmed using a potassium hydroxide (KOH) test. Patients were divided into two groups: Group I and Group II. Group I received oral itraconazole 100 mg twice daily, while Group II received oral terbinafine 250 mg twice daily, both treatments lasting for six weeks. Patients were followed up at the 2nd, 4th, and 6th weeks. Results: The mean age of patients of group I and group II cases was 38.19 ± 13.5 and 35.28 ±13.5 years respectively. Most cases (78.75%) involved both tinea corporis and tinea cruris, indicating a combined presentation. Tinea corporis was the second most common diagnosis, accounting for 10% of cases. Tinea cruris was the least common diagnosis, representing 11.25% of cases. Both groups experienced noticeable improvements in the presence of erythema. Group II showed significant improvement in scaling as compared to group I as shown by significant p values at the end of the second follow up and third follow up. The pruritus scores were substantially improved in group II indicating faster resolution. It appears that both medications are capable of improving clinical symptoms related to dermatophytosis. Conclusion: Both itraconazole and terbinafine are effective treatment options for the treatment of dermatophytosis. However, terbinafine appears to offer superior efficacy in addressing scaling and pruritus, especially in the early stages of treatment. The incidences of adverse drug reactions were low in both groups and both medications were well tolerated.