Abstract

Objective: To evaluate the clinical efficacy of two standardized systemic antifungal treatment protocols.
Methodology: In this randomized clinical trial, a total of 48 patients with clinically and microbiologically confirmed dermatophyte infections were randomly assigned to one of two treatment groups from August 1, 2023, to February 1, 2024. Group 1 (n=24) was administered clotrimazole cream applied twice daily, along with oral terbinafine 250 mg once daily for four weeks. Group 2 received the same topical regimen alongside oral itraconazole 200 mg once daily for the same duration. Clinical outcomes were measured using a symptom scoring system that assessed erythema, scaling, papules, and pruritus.
Results: A majority of patients (77.1%) presented with both tinea corporis and tinea cruris. Trichophyton tonsurans was the most frequently isolated species, accounting for 33.4% of the cultures. After two weeks, 35.4% of participants showed a satisfactory response, while 6.3% exhibited poor improvement. By the sixth week, 79.2% had achieved excellent results, with poor outcomes persisting in 6.3% of cases. After the trial, the cure rate was 64.6%, while 16.7% remained active cases; recurrence was observed in 14.6%, and resistance or lack of response in 4.2%.
Conclusion: No significant difference was identified between the two systemic antifungal regimens in treating superficial dermatophytosis. Although treatment outcomes were not ideal, the findings suggest that higher dosages or extended therapy durations may yield better clinical responses.

Key words: Antifungal agents, dermatophytosis, terbinafine, drug resistance, tinea.