FPIN's Help Desk Answers
Topical Antifungals for Treatment of Onychomycosis
Am Fam Physician. 2016 Nov 1;94(9):734.
What is the rate of resolution of onychomycosis treated with topical antifungal agents?
Topical antifungal agents are effective in treating onychomycosis, with a number needed to treat (NNT) of 7 to 17. (Strength of Recommendation: A, based on consistent findings from good-quality randomized controlled trials.) Efinaconazole 10% topical solution achieved complete cure rates of 15% to 18% vs. 3.3% to 5.5% for vehicle (NNT = 7 to 10). Tavaborole 5% topical solution achieved complete cure rates of 6.5% to 9.1% vs. 0.5% to 1.5% for vehicle (NNT = 13 to 17). Ciclopirox 8% nail lacquer achieved a complete cure rate of 7% compared with 1% for vehicle (NNT = 17). Each medication must be used daily for 48 weeks.
A 2013 review of two randomized, double-blind, vehicle-controlled, parallel-group, mult
1. Elewski BE, et al. Efinaconazole 10% solution in the treatment of toenail onychomycosis. J Am Acad Dermatol. 2013;68(4):600–608.
2. Elewski BE, et al. Efficacy and safety of tavaborole topical solution, 5%, a novel boron-based antifungal agent, for the treatment of toenail onychomycosis. J Am Acad Dermatol. 2015;73(1):62–69.
3. Gupta AK, et al. Ciclopirox 8% nail lacquer in the treatment of onychomycosis of the toenails in the United States. J Am Podiatr Med Assoc. 2000;90(10):495–501.
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