Topical treatments for fungal infections of the skin and nails of the foot.

(95% CI 0.77 to 2.16; Analysis 5.2).
Oxiconazole + fluctic versus oxiconazole
A trial of 1% oxiconazole + fluctic used for 4 weeks versus 1%
oxiconazole used for 4 weeks (n = 201, Elewski 1996) produced
a statistically significant relative reduction in treatment failure of
47% (RR 0.53, 95% CI 0.33 to 0.87; Analysis 5.2), favouring
oxiconazole + fluctic.
Oxiconazole once per day versus oxiconazole twice per day
Ellis 1989 evaluated oxiconazole once per day compared with oxiconazole
twice per day (n = 110) but found no statistically significant
difference in the treatment failure rates (RR 1.23, 95% CI
0.61 to 2.46; Analysis 5.2).
Long-term outcome (12 weeks+)
Clotrimazole four weeks versus clotrimazole one week
In a trial comparing 4 weeks of 1% clotrimazole with 1 week of
1% clotrimazole Bergstresser 1993 found a statistically significant
relative reduction in treatment failure of 53% favouring the longer
Topical treatments for fungal infections of the skin and nails of the foot. (Review)
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
treatment time (RR at 12 weeks 0.47, 95% CI 0.28 to 0.78;
Analysis 5.4).
Allylamines one to two weeks versus azoles one to two weeks
Short-term outcome (two weeks)
Ten trials (n = 1519, Ablon 1996; Bojanovsky 1985; Evans 1993a;
Evans 1993b; Haas 1985; Leenutaphong 1999; Sanchez 1994
Schopf 1999; Smith 1990b; Smith 1992) comparing 1% allylamines
(naftifine, terbinafine) with 1% azoles (bifonazole, clotrimazole,
oxiconazole) used for 1 to 2 weeks showed a small, not
statistically significant, difference in favour of allylamines; RR of
treatment failure at 2 weeks 0.86 (95% CI 0.70 to 1.06; Analysis
6.1). There was considerable variation in the results of the individual
trials (I 2 = 60%).
A L’Abbé plot of the outcomes at two weeks (Figure 3) demonstrates
that the allylamines generally had similar treatment failure
rates to the azoles, with a wide variation in failure rates.
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