Itraconazole therapy for recalcitrant dermatophyte infections

Five patients with recurrent Trichophyton rubrum infections had become unresponsive to topical and oral antifungal therapy. These patients were treated in an open trial of itraconazole, a new oral antifungal medication. Each patient responded promptly to therapy within 1 month and showed marked improvement at the end of 3 to 6 months of therapy. Complete clearing of toenail infections was not achieved in this limited trial and recurrences occurred in the four patients who had toenail infections. The drug was well tolerated and no adverse effects were observed. Itraconazole appears to be an effective drug for relief of clinical aspects of recalcitrant dermatophyte infections. Long-term safety and prevention of recurrence remain to be established.