From the Guidelines
The treatment for Trichophyton mentagrophytes infection is oral terbinafine 250 mg daily for 2-6 weeks for skin infections or 6-12 weeks for nail infections, due to its broad and potent fungicidal effects against dermatophytes. When considering treatment options, it's essential to weigh the potential benefits and risks, particularly in patients with pre-existing liver or kidney disease, as terbinafine clearance is decreased in these cases 1. Some key points to consider when prescribing terbinafine include:
- Its strong lipophilic properties, which allow it to distribute well in skin and nails 1
- The potential for rare but serious adverse reactions, such as Stevens-Johnson syndrome and toxic epidermal necrolysis 1
- The need for baseline liver function tests and a complete full blood count in patients with a history of heavy alcohol consumption, hepatitis, or haematological abnormalities 1
- The importance of good hygiene practices during treatment, including keeping affected areas clean and dry, using separate towels, wearing breathable footwear, and treating all infected family members simultaneously to prevent reinfection. It's also crucial to monitor patients for potential side effects, such as gastrointestinal events (49%) or dermatological events (23%), and to be aware of the rare reports of serious hepatic toxicity, which have occurred usually in patients with pre-existing liver disease 1.
From the FDA Drug Label
Griseofulvin oral suspension, USP is indicated for the treatment of dermatophyte infections of the skin not adequately treated by topical therapy, hair and nails, namely: ... Trichophyton mentagrophytes Terbinafine, an allylamine antifungal, inhibits biosynthesis of ergosterol, an essential component of fungal cell membrane, via inhibition of squalene epoxidase enzyme. ... Terbinafine has been shown to be active against most strains of the following microorganisms both in vitro and in clinical infections: Trichophyton mentagrophytes
The treatment for Trichophyton mentagrophytes infection is griseofulvin (PO) or terbinafine (PO), as both drugs have been shown to be effective against this fungus 2 3.
- Griseofulvin is indicated for the treatment of dermatophyte infections, including those caused by Trichophyton mentagrophytes.
- Terbinafine has been shown to be active against Trichophyton mentagrophytes in vitro and in clinical infections.
From the Research
Treatment Options for Trichophyton mentagrophytes Infection
- Oral itraconazole 200 mg per day for 4-8 weeks is considered an effective treatment for Trichophyton mentagrophytes infection, with a cure rate significantly higher than terbinafine 4
- Griseofulvin 500-1000 mg for 2-6 months may be effective, while fluconazole has no record of successful treatment 4
- Voriconazole and ravuconazole have potential therapeutic efficacy, but more research is needed to confirm their effectiveness 4
- Topical therapy alone has limited therapeutic efficacy, but combining it with oral antifungals can be an alternative treatment option 4
Topical Treatment Options
- Clotrimazole, miconazole, tolnaftate, and griseofulvin have demonstrated activity against Trichophyton mentagrophytes infection when applied topically 5, 6
- Isoconazole nitrate and diflucortolone valerate therapy has been effective in treating tinea corporis due to Trichophyton mentagrophytes 7
- Topical griseofulvin has been shown to be effective in treating dermatophytoses, including Trichophyton mentagrophytes infection, with a mycological cure rate of 79.2% after 4 weeks of treatment 8
Comparison of Treatment Options
- Oral itraconazole has been shown to be more effective than terbinafine in treating Trichophyton mentagrophytes infection 4
- Topical griseofulvin has been shown to be more effective than placebo in treating dermatophytoses, including Trichophyton mentagrophytes infection 8
- The combination of oral and topical antifungals may be a more effective treatment option than using a single treatment approach 4, 7