From the Research
For a severe persistent fungal infection of the gluteal cleft, oral terbinafine is typically prescribed at a dose of 250 mg once daily for 2-6 weeks, depending on the severity and response to treatment, as supported by the study published in 1999 1.
Treatment Duration and Dosage
The treatment duration may need to extend to 12 weeks in particularly resistant cases. This systemic approach is often necessary when topical treatments have failed or when the infection is extensive.
- The dosage of 250 mg once daily is based on the study published in 1999 1, which demonstrated the efficacy of terbinafine in treating superficial dermatophyte infections.
- The treatment duration of 2-6 weeks is supported by the study published in 1997 2, which evaluated the efficacy of 6 weeks treatment of terbinafine in tinea unguium.
Additional Treatment Considerations
Alongside oral medication, topical terbinafine 1% cream applied twice daily to the affected area can help accelerate healing.
- It's essential to continue treatment for the full prescribed duration, even if symptoms improve earlier, to prevent recurrence.
- Good hygiene practices are crucial during treatment, including keeping the area clean and dry, wearing loose cotton underwear, and changing clothes after sweating.
Mechanism of Action and Side Effects
Terbinafine works by inhibiting squalene epoxidase, an enzyme needed for fungal cell membrane synthesis, effectively killing the fungus rather than just preventing growth.
- Potential side effects include gastrointestinal disturbances, headache, and rarely liver function abnormalities, so liver function tests may be recommended before and during extended treatment courses, as noted in the study published in 1999 1.