Fluconazole Dosing for Tinea Corporis
For tinea corporis, fluconazole 150 mg once weekly for 2-4 weeks is an effective and recommended dosing regimen. 1, 2
Dosing Options for Tinea Corporis
- Fluconazole 150 mg once weekly for 2-4 weeks is effective for treating tinea corporis with minimal side effects 1, 2
- Alternative dosing includes fluconazole 50-100 mg daily for 2-3 weeks 3
- Once weekly dosing offers better compliance compared to daily regimens 1
Evidence and Efficacy
- Clinical studies have shown that fluconazole 150 mg once weekly for 4-6 weeks achieved clinical cure in 74% of patients with tinea corporis/cruris 2
- Total severity scores of clinical symptoms (pruritus, erythema, scaling, burning/pain, vesiculation) were significantly reduced from 7.1 before treatment to 1.5 after treatment with once weekly fluconazole 150 mg 1
- Mycological cure rates of 78% have been reported with weekly fluconazole regimens 2
Treatment Considerations
- While topical antifungal agents are first-line for limited tinea corporis, systemic therapy is indicated for extensive disease, multiple sites of infection, or cases unresponsive to topical treatment 3
- Fluconazole achieves high concentrations in the stratum corneum and has a long elimination half-life, making once weekly dosing effective 1
- Treatment should continue until clinical and mycological cure is achieved 2
Alternative Systemic Antifungal Options
- Itraconazole 100 mg daily for 2 weeks or 200 mg daily for 7 days is an effective alternative 3, 4
- Terbinafine 250 mg daily for 1-2 weeks can also be used, particularly for Trichophyton species infections 3
- For fluconazole-resistant cases, itraconazole may be preferred, with serum levels >0.2 μg/ml associated with successful treatment outcomes 4
Safety and Monitoring
- Fluconazole is generally well-tolerated with few side effects reported in clinical trials 1, 2
- In one study, only 7.5% of patients experienced treatment-related adverse events with fluconazole compared to 12.5% with griseofulvin 2
- Common side effects may include gastrointestinal symptoms; one study reported a patient with pre-existing gastritis had to discontinue treatment due to abdominal pain 5
Special Considerations
- For athletes, particularly wrestlers and judo practitioners who have higher rates of tinea corporis (T. corporis gladiatorum), systemic therapy may be particularly beneficial 6
- In high-risk athletic populations, fluconazole has been used prophylactically (100 mg daily for 3 days) to prevent outbreaks, though this should only be done in consultation with an infectious disease expert 6
- Treatment failure should prompt investigation of compliance issues, inadequate absorption, or resistant organisms 4