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SHORT COMMUNICATION
Year : 1992  |  Volume : 58  |  Issue : 2  |  Page : 108-110

Comparative study of ketoconazole and griseofulvin in dermatophytoses




Correspondence Address:
R P Sharma


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Source of Support: None, Conflict of Interest: None


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  Abstract 

A total of 120 patients of dermatophytoses were divided into two groups. One was treated with ketoconazole and other with griseofulvin for 4 weeks. In addition a placebo cream/lotion was applied locally. Ketoconazole produced 90 percent cure while with griseofulvin it was 76.7 percent. No significant adverse effect (s) were noticed in either group(s). Clinical response to ketoconazole was 13.3 percent better, however cost efficacy ratio vis a vis griseofulvin was 6:1.


Keywords: Dermatophytoses, Ketoconazole, Griseofulvin


How to cite this article:
Sharma R P, Sharma N K, Gupta S. Comparative study of ketoconazole and griseofulvin in dermatophytoses. Indian J Dermatol Venereol Leprol 1992;58:108-10

How to cite this URL:
Sharma R P, Sharma N K, Gupta S. Comparative study of ketoconazole and griseofulvin in dermatophytoses. Indian J Dermatol Venereol Leprol [serial online] 1992 [cited 2020 Mar 28];58:108-10. Available from: http://www.ijdvl.com/text.asp?1992/58/2/108/3764



  Introduction Top


Ketoconazole is a new systemic antifungal drug, whose role in treatment of dermatophytoses is quite recognised. [1],[2],[3],[4] It is claimed to possess a broader spectrum of activity. Griseofulvin is a traditionally used systemic antifungal agent. Present study was undertaken to compare relative efficacy and cost of treatment with the two.


  Materials and Methods Top


A total of 120 patients of dermatophytoses were selected for the study. In each case diagnosis was made clinically and confirmed by KOH examination. Culture was done later to determine the species responsible for infection. First presenting case was put on ketoconazole (200-400 mg/day) and the second on griseofulvin (500 mg-1 gm/ day). Thereafter all odd numbered cases were treated with ketoconazole and the even with griseofulvin. Each patient was followed up weekly. Any side effect(s), clinical response and mycological findings were recorded on each visit. On basis of the therapeutic response, improvement was graded as follows

Grade 0 No Improvement

Grade I Persistence of few papular lesions or erythema with mild to moderate itching.

Grade II . Scaly lesions with or without itching.

Grade III : Disappearance of original lesion(s) with or without residual pigmentation.

Cost of treatment was determined by first calculating the daily dose on basis of the average cost of five commonly used brands of each drug from MIMS index and thereafter the weekly and the over all cost was calculated depending on duration of therapy.

At the end of 4 weeks the final assessment was done.


  Results Top


In each group, there were 60 cases which included tinea corporis (22), tinea cruris (14), tinea manum (10), tinea pedis (8) and the mixed type(s) (6). All cases were KOH positive and fungal species were subsequently isolated on culture. These were trichophyton rubrum (94), trichophyton mentagrophytes (14) and epidermophyton floccosum (12).

Response to treatment according to clinical type(s) is shown in [Table - 1]. There was no statistical significant difference in overall clinical cure rates in either of the groups.

Ketoconazole appeared to be better than griseofulvin in cases caused by trichophyton rubrum.

Cost efficacy ratio of ketoconazole with griseofulvin was 6:1.

No serious adverse effects in either group were observed. Only mild nausea and headache were seen in one ketoconazole treated and in two griseofulvin treated patients. These adverse effects disappeared within 2 to 3 days without discontinuing the treatment in either group.


  Comments Top


In this study 90 percent cure rate was found with ketoconazole while in earlier studies it varied from 60 to 100 percent. [1],[2],[3],[4],[5]

With this drug there was quicker improvement in cases of tinea corporis and tinea cruris caused by trichophyton rubrum. Similar observations were also reported earlier by Hay et al.[5]

Cure rate with griseofulvin was found 76.7 percent in this study, where as 74 percent and 77.4 percent cure rates have been reported earlier by Hay et al [5] and Muley et al [6] respectively.

The overall difference in clinical response was 13.3 percent which is not statistically significant. Cost wise treatment with griseofulvin is economical. Therefore practically griseofulvin still remains suitable systemic antifungal agent, although in certain specific situations ketoconazole may be preferred.

 
  References Top

1.Welsh 0, Rodriquez M.Treatment of dermatophytoses with Ketoconazole. Rev Infect Dis 1980; 2 : 582 - 5.  Back to cited text no. 1    
2.Jones HE, Simpson JM, Artis WH. Oral Ketoconazole, an effective and safe treatment for dermatophytoses. Arch Dermatol 1981; 117: 129-34.  Back to cited text no. 2    
3.Cox FW, Stiller RL, South DA, et al. Oral Ketoconazole for dermatophyte infections. J Amer Acad Dermatol 1982; 6 : 455 - 62.  Back to cited text no. 3  [PUBMED]  
4.Symoens J, Moens M, Dorn J, et al. An evaluation of twoyears of clinical experience with Ketoconazole. Rev Infect Dis 1980; 2: 674-91.  Back to cited text no. 4    
5.Hay RJ, Clayton YM, Criffiths WAD, et al. A comparative double blind study of Ketoconazole and griseofulvin in dermatophytoses. Brit J Dermatol 1985; 112: 691-6.  Back to cited text no. 5    
6.Muley DM, Ahuja BB, Garg AK. A study on the etiology and treatment of dermato­phytoses in Delhi. Ind J Dermatol Venereol 1970; 36: 215-20.  Back to cited text no. 6    


    Tables

[Table - 1]

This article has been cited by
1 Prescription auditing of griseofulvin in a tertiary care teaching hospital
Bai Kirubha, M.H.
Indian Journal of Dermatology, Venereology and Leprology. 2009; 75(6): 588-592
[Pubmed]



 

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