A prospective Cross Sectional Cohort Study in South East Asia to Evaluate Comparative efficacy of high dose short term versus low dose long term itraconazole therapy for superficial dermatophyte infections

Background: Superficial dermatophyte infections are highly prevalent in tropical countries and are increasingly present as chronic, recalcitrant disease in South Asia. Itraconazole is widely used for tinea corporis and tinea cruris, but the optimal dosing regimen remains uncertain.Objectives: To compare a high-dose short-term versus low-dose long-term itraconazole regimen in patients with superficial dermatophyte infections.Methods: This prospective single-center cross-sectional comparative study assessed treatment efficacy for short term high dose vs. long term low dose Itraconazol regimen (Group A: 200mg BID for 8 weeks vs. Group B: 100mg QD for 12 weeks). Demographic and clinical data, prior treatments and symptom duration were recorded. Clinical severity and patient satisfaction were assessed every 2 weeks; mycological response was evaluated by potassium hydroxide microscopy at end of therapy. Results: A total of 123 patients were recruited (54 and 69 patients in Group A and B, respectively). The Patients had more chronic and extensive disease, with longer symptom duration, universal skin-fold involvement and higher prior itraconazole and topical steroid use. Itraconazole 200mg BID for 8 weeks showed greater patients satisfaction (94.44%) compared to 4.35 % in Group B (100mg QD for 12 weeks).Conclusions: Resistance to oral antifungals is a growing problem globally, in particular in South Asian population. High dose short term regimen was favored to achieve complete clearance over long term low dose regimen with significant patients’ satisfactions.