Abstract
Purpose： To clarify the specific methods used for the treatment of onychomycosis in clinical settings and to assess changes that have occurred in treatment patterns with the advent of topical antifungals for onychomycosis.
Methods: Questionnaires were mailed to 70 dermatologists nationwide for the survey. Responses from the returned questionnaires were aggregated and analyzed.
Results & Conclusion: Questionnaires were returned by 52 of the dermatologists surveyed(74.3%). Therapeutic antifungals prescribed to onychomycosis patients were oral agents(41.4%), topical agents specifically for onychomycosis(42.9%), and other topical agents(37.7%)and the prescription rates among them were almost same. Although there were no significant differences in the prescription rates of topical agents for onychomycosis among the facilities, the prescription rate of oral antifungals was lower in university hospital(33.2%)and general hospitals(29.8%)than in clinics(51.9%).
Current guidelines recommend oral antifungals as first-line drugs for the treatment of onychomycosis. However, our results showed that the prescription rate of these drugs is currently lower than expected. The reason for these lower than expected prescription rates may be as follows. Although many dermatologists were aware of the high efficacy of oral antifungals, they reported hesitation in actively prescribing these drugs due to concerns such as “drug interactions” and “liver dysfunction”.
In order to improve the prescription rate of oral antifungals, the development and availability of new oral antifungals are awaited. The introduction of promising new oral antifungals and the development of a proper understanding of onychomycosis treatments are necessary to increase the prescription rate of oral antifungals.
