Recurrence, reinfection and long-term efficacy of antifungals in onychomycosis by 2013

Sergeev A.Y., Mokina E.V., Savchenko N.V., Sergeev V.Yu., Burtseva G.N.

All-Russian National Academy of Mycology, Moscow

The practice and future developments in topical and systemic treatments for onychomycosis often meet with problems of evaluating end-point clinical and mycological cure, establishing long-term efficacy, the rates of recurrence and reinfection. This may add to the discrepancy between the data of modern clinical trials resulting in significant variation of efficacy data (20 to 60 per cent). The meta-analyses of major international trials in long-term efficacy offer some clues to the causes of treatment failure and possible efficient solutions. We have conducted a 4year study on longterm efficacy of modern regimens of antifungal treatment in onychomycosis. Reinforced with new data on comparative efficacy of topical antifungals, such as allylamines including 1% naftifine, various imidazole formulations and other compounds, we may be confident now with possibility of effective treatment and prevention of the reinfection in onychomycosis. The Russian developments of the recent years include new technologies and recommendations on evaluation of clinical and mycological cure rates, individual and communal prevention guidelines.