Patterns of culture positivity and antifungal sensitivity in dermatophytosis

Abstract

Background: Antifungal drug resistance and a lack of clinical response in 20% of cases of dermatophytosis calls for an evaluation of resistant dermatophytes using a standardized simple and reproducible in vitro assay, to allow clinician to select the appropriate antifungal agent based on the susceptibility of the isolate to the antifungal agent. Objective: The objective of this study was to clinically correlate the patterns of antifungal susceptibility of dermatophyte isolates and study resistance patterns and cross-resistance among antifungal agents. Materials and Methods: A study was conducted with 60 patients. At visit 1, the patient was started on empiric treatment with terbinafine 250mg daily for 2 weeks. Skin scraping for potassium hydroxide (KOH) mount and fungal culture and antifungal susceptibility testing was collected. After 2 weeks of therapy, the treatment was either continued or changed to a sensitive antifungal agent depending on the susceptibility testing results. The patient was clinically reevaluated every fortnightly. The patient completed a total of 4 weeks of the susceptible antifungal agent. The outcome of therapy was assessed by means of a skin scraping for KOH mount examination. Results: There were 44 males and 16 females. Maximum belonged to the age-group 30–40 years. Maximum patients had tinea corporis (51.6%) followed by tinea cruris (20%). Conclusion: The study provided information regarding clinico-mycological correlation of terbinafine, which revealed terbinafine to be the most effective antifungal agent clinically as well as mycologically.

Keywords

• antifungal culture and sensitivity
• dermatophytosis
• itraconazole
• terbinafine