Don’t prescribe oral antifungal therapy for suspected nail fungus without confirmation of fungal infection.
|Rationale and Comments:||About half of nails with suspected fungus do not have a fungal infection. Because other nail conditions, such as nail dystrophies, may look similar in appearance, it is important to ensure accurate diagnosis of nail disease before beginning treatment. By confirming a fungal infection, patients are not inappropriately at risk for the side effects of antifungal therapy, and nail disease is correctly treated.|
|References:||• Roberts DT, Taylor WD, Boyle J; British Association of Dermatologists. Guidelines for treatment of onychomycosis. Br J Dermatol. 2003 Mar;148(3):402-10.
• Mehregan DR, Gee SL. The cost effectiveness of testing for onychomycosis versus empiric treatment of onychodystrophies with oral antifungal agents. Cutis. 1999 Dec;64(6):407-10.