A multicentre trial of terbinafine in patients with chromoblastomycosis: Effect on clinical and biological criteria

A multicentre, pilot clinical trial of terbinafine was performed on 35 patients with active chromoblastomycosis to evaluate its potential as a novel therapy for this fungal disorder. The clinical results were excellent, In patients infected with Fonsecaea pedrosoi, a mycological cure was observed in 41.4%, 74.1% and 82.5% of patients after 4, 8 and 12 months of therapy, respectively. The mean number of fungal cells fell by approximately 70% in 4 months. The efficacy of terbinafine in Cladophialophora carrionii-infected patients was even higher. For the first time in this disease, total cure was observed in imidazole-refractory patients and chronic cases. Forty-two patients were evaluated for safety. Minor laboratory abnormalities were occasionally observed, including transient elevations of hepatic transaminases and reduced neutrophil counts. Statistical analysis showed a trend toward a decrease in specific immunoglobulin serum levels, but found no significant association with any criteria. Given that total cure is generally achieved, even in the chronic form of this disease, with only minor side effects, terbinafine should be considered as the drug of choice in the treatment of chromoblastomycosis.