From the Research
Fluconazole should be prescribed at 150 mg once weekly for 2-4 weeks for the treatment of tinea corporis, as this regimen has been shown to be efficacious and safe 1.
Key Considerations
- Topical antifungal medications like clotrimazole, miconazole, or terbinafine are generally preferred as initial treatment for uncomplicated tinea corporis, applied twice daily for 1-3 weeks.
- Oral therapy with fluconazole is usually reserved for extensive disease, failure of topical treatment, immunocompromised patients, or involvement of hair-bearing areas.
- Patients should be monitored for potential side effects including gastrointestinal upset, headache, and rarely liver dysfunction.
- The mechanism of action of fluconazole involves inhibiting the fungal cytochrome P450 enzyme 14α-demethylase, preventing the conversion of lanosterol to ergosterol, an essential component of the fungal cell membrane.
Supporting Evidence
- A study published in 1998 demonstrated that fluconazole 150 mg once weekly for 2-4 weeks was an effective and safe regimen for the treatment of tinea corporis and cruris 1.
- Another study published in 1999 reviewed the effectiveness of oral antifungal agents, including fluconazole, in the treatment of tinea corporis and cruris, and found that 150 mg once weekly for 2-3 weeks was an effective regimen 2.
- More recent studies have focused on the treatment of recurrent and therapy-refractory dermatophytoses, and have highlighted the importance of considering terbinafine resistance and using alternative treatments such as itraconazole 3.
- A review published in 2020 emphasized the importance of familiarizing oneself with the clinical presentation and treatment of tinea corporis, and noted that topical antifungals are the standard treatment, with oral antifungals reserved for more severe or extensive cases 4.