Continuing medical educationOnychomycosis: Treatment and prevention of recurrence
Section snippets
Overview of treatment
The goals of onychomycosis therapy are to both eliminate the infecting fungal organism and restore the nail to its normal state as it grows. Patients should be counseled that this process can take some time because fingernails grow about 2 to 3 mm per month and toenails grow 1 to 2 mm per month. The US Food and Drug Administration (FDA) requires treatment efficacy endpoints that are based on clinical examination and negative cultures/stains for drug approvals.1 Endpoints used in clinical trials
Prevention of recurrence
After treatment of onychomycosis, recurrences (ie, relapse [same infection after incomplete cure] or reinfection [same infection after complete cure]) occur at a rate of 20% to 25%.4, 163, 164 In a retrospective chart review on patients with complete cure treated with oral terbinafine for toenail onychomycosis who then used a topical antifungal for prophylaxis (n = 320), the recurrence rate was significantly lower in patients receiving prophylaxis.25 The ideal duration of prophylaxis is
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Date of release: April 2019
Expiration date: April 2022
Funding sources: None.
Dr Scher has received honoraria from MOE Medical Devices, Epihealth, Medicxi, and Valeant. Dr Lipner has received grants for clinical trials from MOE Medical Devices.
Reprints not available from the authors.