A comparative double blind study of ketoconazole and griseofulvin in dermatophytosis

Abstract

The merits of oral ketoconazole and griseofulvin in dermatophytosis have been compared in a double blind study on 74 patients with 152 infected sites. The initial daily doses were 200 mg and 500 mg, respectively, but these were doubled after 3 mo. if there was an inadequate clinical response. Treatment was continued either until clinical and mycological remission was achieved or a year of therapy had been given. Seventy-five percent (total 80) and 74% (total 72) of all infected sites treated with ketoconazole and griseofulvin, respectively, were cleared of infection. However, in toenail infections the respective cure rates were only 21% and 17%. Ketoconazole appeared to act more rapidly in curing tinea corporis or tinea cruris due to Trichophyton rubrum, whereas griseofulvin was superior in T. interdigitale infections. No serious side-effects were encountered in either treatment group. In view of the slight risk of drug-induced hepatitis, ketoconazole is best reserved as a 2nd-line drug for toenail infections unless there are specific indications, such as griseofulvin intolerance. In these cases liver function tests should be monitored regularly throughout therapy.