Hoe effectief is lokale behandeling bij onychomycose van de teennagels

Fungal infection (onychomycosis) of the nails is a common ailment seen in GP practice, often found to be annoying and unsightly. In most cases it involves the greater toenail. The only clinically proven effective treatment is oral terbinafine or an imidazole for at least 3 months. GP's and dermatologists regard onychomycosis primarily as a cosmetic problem and not so much a medical one, therefore understandably being hesitant or reluctant to prescribe oral terbinafine. If treatment is chosen for more extensive forms of onychomycosis, oral therapy remains first choice however. With less severe, more limited forms of onychomycosis, local therapy might be a good alternative. If proven effective, this could lead to fewer prescriptions of oral terbinafine which is desirable given the rare but potentially serious side effects. A recent Cochrane Review states that more research into the effectiveness of local treatment is needed. Little research has been done into one of the most frequently used antimycotic agents in the Netherlands, miconazole. Given the already proven effectiveness and potential side effects of terbinafine orally, this study focus is on comparing the two most commonly used topical agents (miconazole and amorolfine) versus placebo. The aim of this study is to investigate the effect of local treatment of onychomycosis of the toenail(s) with miconazole or amorolfine as compared to placebo.

Local antimycotic treatment of fungal toenail infection is more effective than placebo

Total treatment and follow-up of 6 months

Miconazol (Daktarin); Amorolfine (Loceryl)