Once-weekly oral doses of fluconazole 150 mg in the treatment of tinea pedis

ABSTRACT

Seventy adult out-patients with tinea pedis participated in a multicentre open non-comparative study of the safety and efficacy of once-weekly doses of oral fluconazole 150 mg. A mean of 3 doses of fluconazole was administered; patients infected with Candida required an average of 2 doses compared to 3–4 doses in patients infected with other organisms. Clinical cure was obtained in 45 of 61 (74%) evaluable patients at the last post-treatment evaluation, with 15 patients being substantially improved and one patient failing clinically. At long-term follow-up, 28–30 days after the last dose was administered, 46 of 60 (77%) patients were clinically cured, 13 (22%) patients were improved and one patient failed. Trichophyton rubrum was isolated most frequently (47 of 60 mycologically evaluable patients). Mycological evidence of infection was eradicated from 52 of 60 (87%) patients post-treatment. At the long-term follow-up, infection was eradicated from 46 of 59 (78%) patients, persisted in five (8%) patients and relapsed in eight (14%) patients, six of whom were infected with T. rubrum and two of whom were infected with both T. rubrum and Candida. The number of doses received did not correlate with either the mycological response or relapse rates at long-term follow-up. The subgroup of 16 patients with infection of the sole of the foot, which is often considered to be more difficult to eradicate, responded similarly. Only 5 of 70 (7%) fluconazole-treated patients reported adverse effects, which were mild to moderate in severity, transient and did not result in discontinuation of therapy. The high level of tolerance to fluconazole in comparison to some other oral antifungals and the convenience of the once-weekly oral-administration schedule relative to existing topical and oral therapies, make once-weekly oral doses of fluconazole a valuable alternative for the treatment of tinea pedis.