European Journal of Molecular & Clinical Medicine

Abstract

Background: Onychomycosis is a chronic fungal infection of the nail, characterized by nail
discoloration, subungual hyperkeratosis, and onycholysis. The involved pathogens are
dermatophytes, yeasts (Candida), and non-dermatophyte molds.Dermatophytes such as
Trichophyton rubrum and Trichophyton mentagrophytes are the most common agents of
onychomycosis, with higher prevalence of the infection in toenails than in fingernails. Candida
albicans affects almost exclusively the fingernails, and accounts for 10% of toenail
onychomycosis.
Itraconazole is a broad-spectrum antifungal drug which is active against a range of fungal
species, including yeasts, dermatophytes and some non-dermatophyte molds, is a more
convenient antifungal drug for different types of onychomycosis. Itraconazole is licensed at a
dose of 200 mg daily for 12 weeks continuously or intermittently as pulse therapy at a dose of
400 mg daily for 1 week per month for 2-3 pulses in fingernail infections and 3-4 pulses for
toenail disease.Although itraconazole pulse therapy has proven to be an effective and
acceptable onychomycosis therapies, the complete cure rate remains unsatisfactory, indicating
that 3-4 cycles of pulse therapy for toenail onychomycosis might be inadequate for severe cases
of onychomycosis. Thus, the development of a more effective and suitable therapeutic regimen
to improve the complete cure rate is necessary.