Fungicidal activity plus reservoir effect allow short treatment courses with terbinafine in tinea pedis

Terbinafine, a synthetic allylamine, exerts fungicidal activity
against dermatophytes, the causative pathogens of tinea pedis. As
proven in numerous clinical trials, tinea pedis can be effectively
and safely treated by topical terbinafine. In fact, a 1-week
application of terbinafine 1% cream eradicated fungal pathogens at
least as effectively as 4-week treatment courses with topical azole
derivative antifungals and showed lower relapse rates. A new
innovative single-application formulation of terbinafine 1% in a
film-forming solution produces a high concentration gradient on the
skin surface and enables a prolonged (up to 13 days) exposure of
the skin to terbinafine. High drug penetration into the skin
results in an otherwise not obtained drug reservoir in the horny
layer, the location of dermatophytes in tinea pedis. Although azole
antimycotics can also effectively penetrate into the horny layer of
the skin, short-term therapy might not be feasible due to its
primarily fungistatic activity against dermatophytes. Thus, we
conclude that the high efficacy of short-term treatment with
terbinafine in patients with tinea pedis is possible due to its
fungicidal activity coupled with a distinct reservoir formation in
the upper layers of the epidermis. Copyright (C) 2008 S. Karger AG,
Basel.