A study of treatment and compliance on onychomycosis

Yang Won Lee, Moo Kyu Suh, Kwanghoon Lee, Won Young Ho, Kyu Joong Ahn, Ki Hong Kim

Research output: Contribution to journalReview article

4 Citations (Scopus)

Abstract

Onychomycosis is a common infection of the nail, with its prevalence estimated at 20 percent. However, a significant proportion of patients, perhaps as high as 20-40%, is classified as treatment failures and/or relapse following treatment. Several factors such as antifungal resistance, dermatophytoma, preexisting nail dystrophy, reinfection from the surrounding infected tissue can influence the success of a particular monotherapy. Therefore, the combination of antifungal drugs to produce synergistic activity is one possible advance towards achieving higher cure rates. The combination therapies have been known to increase antifungal spectrum and potency of drugs, facilitate drug delivery and reduce fungal load in nail plate. Their final goals are to increase a tolerance and maximize the therapeutic efficacy. Considering the special circumstance of the nail, the oral/topical combination is the most appropriate, for it increases drug concentration in the nail plate by mutual complementary cooperation. Treatment of onychomycosis requires long-term systemic medication of antifungal agent, and its complete cure rates were only 30-50%. Clinical success rate is determined by patients compliance which depends on treatment method and period. In practice, compliance of long-term treatment was very low, possibly attributable to longer treatment duration. Another challenge was relapse and/or reinfection after cure. The authors have attempted to address the issue concerning the method of treatment and duration of action for oral antifungal agents commonly used in practice today, and whether there is a statistically-significant difference among those drugs, based on the studies analyzing patient compliance.

Original languageEnglish
Pages (from-to)83-90
Number of pages8
JournalKorean Journal of Medical Mycology
Volume10
Issue number3
Publication statusPublished - 2005 Sep 1

Fingerprint

Onychomycosis
Compliance
Nails
Antifungal Agents
Therapeutics
Patient Compliance
Pharmaceutical Preparations
Recurrence
Drug Combinations
Treatment Failure

All Science Journal Classification (ASJC) codes

  • Infectious Diseases

Cite this

Lee, Y. W., Suh, M. K., Lee, K., Ho, W. Y., Ahn, K. J., & Kim, K. H. (2005). A study of treatment and compliance on onychomycosis. Korean Journal of Medical Mycology, 10(3), 83-90.
Lee, Yang Won ; Suh, Moo Kyu ; Lee, Kwanghoon ; Ho, Won Young ; Ahn, Kyu Joong ; Kim, Ki Hong. / A study of treatment and compliance on onychomycosis. In: Korean Journal of Medical Mycology. 2005 ; Vol. 10, No. 3. pp. 83-90.
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Lee, YW, Suh, MK, Lee, K, Ho, WY, Ahn, KJ & Kim, KH 2005, 'A study of treatment and compliance on onychomycosis', Korean Journal of Medical Mycology, vol. 10, no. 3, pp. 83-90.

A study of treatment and compliance on onychomycosis. / Lee, Yang Won; Suh, Moo Kyu; Lee, Kwanghoon; Ho, Won Young; Ahn, Kyu Joong; Kim, Ki Hong.

In: Korean Journal of Medical Mycology, Vol. 10, No. 3, 01.09.2005, p. 83-90.

Research output: Contribution to journalReview article

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N2 - Onychomycosis is a common infection of the nail, with its prevalence estimated at 20 percent. However, a significant proportion of patients, perhaps as high as 20-40%, is classified as treatment failures and/or relapse following treatment. Several factors such as antifungal resistance, dermatophytoma, preexisting nail dystrophy, reinfection from the surrounding infected tissue can influence the success of a particular monotherapy. Therefore, the combination of antifungal drugs to produce synergistic activity is one possible advance towards achieving higher cure rates. The combination therapies have been known to increase antifungal spectrum and potency of drugs, facilitate drug delivery and reduce fungal load in nail plate. Their final goals are to increase a tolerance and maximize the therapeutic efficacy. Considering the special circumstance of the nail, the oral/topical combination is the most appropriate, for it increases drug concentration in the nail plate by mutual complementary cooperation. Treatment of onychomycosis requires long-term systemic medication of antifungal agent, and its complete cure rates were only 30-50%. Clinical success rate is determined by patients compliance which depends on treatment method and period. In practice, compliance of long-term treatment was very low, possibly attributable to longer treatment duration. Another challenge was relapse and/or reinfection after cure. The authors have attempted to address the issue concerning the method of treatment and duration of action for oral antifungal agents commonly used in practice today, and whether there is a statistically-significant difference among those drugs, based on the studies analyzing patient compliance.

AB - Onychomycosis is a common infection of the nail, with its prevalence estimated at 20 percent. However, a significant proportion of patients, perhaps as high as 20-40%, is classified as treatment failures and/or relapse following treatment. Several factors such as antifungal resistance, dermatophytoma, preexisting nail dystrophy, reinfection from the surrounding infected tissue can influence the success of a particular monotherapy. Therefore, the combination of antifungal drugs to produce synergistic activity is one possible advance towards achieving higher cure rates. The combination therapies have been known to increase antifungal spectrum and potency of drugs, facilitate drug delivery and reduce fungal load in nail plate. Their final goals are to increase a tolerance and maximize the therapeutic efficacy. Considering the special circumstance of the nail, the oral/topical combination is the most appropriate, for it increases drug concentration in the nail plate by mutual complementary cooperation. Treatment of onychomycosis requires long-term systemic medication of antifungal agent, and its complete cure rates were only 30-50%. Clinical success rate is determined by patients compliance which depends on treatment method and period. In practice, compliance of long-term treatment was very low, possibly attributable to longer treatment duration. Another challenge was relapse and/or reinfection after cure. The authors have attempted to address the issue concerning the method of treatment and duration of action for oral antifungal agents commonly used in practice today, and whether there is a statistically-significant difference among those drugs, based on the studies analyzing patient compliance.

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Lee YW, Suh MK, Lee K, Ho WY, Ahn KJ, Kim KH. A study of treatment and compliance on onychomycosis. Korean Journal of Medical Mycology. 2005 Sep 1;10(3):83-90.