Comparing the Efficacy of Oral 200 Milligram Voriconazole Once a Day Vs Twice a Day in the Treatment of Resistant Dermatophyte Infections (Tinea Corporis and Tinea Cruris)

Abstract

Background:  Treatment of dermatophyte infection in our country is becoming difficult due to the developing resistance to traditional antifungal agents. Assessing the effectiveness and feasibility of a newer antifungal drug like voriconazole is the need of the hour in resistant cases. Objective:  To compare the efficacy of oral 200 milligram voriconazole once a day vs twice a day in the treatment of resistant dermatophyte infections (tinea corporis and cruris). Methods:  This Randomized Controlled Trial (registration number NCT06680544.) was carried out in Outpatient Dermatology Department, Sheikh Zayed Hospital Rahim Yar Khan, Pakistan. Total 106 patients were divided into two groups, Group A and Group B, each consisting of 53 patients. Group A was given oral voriconazole 200mg once a day and Group B was given twice a day for a maximum of 28 days. Efficacy was assessed at day 14 and day 28, and relapse was noted at the 2-month follow-up visit. Data was recorded on a preformed Proforma for each patient and analyzed using SPSS 24. A p-value of less than 0.05 was considered statistically significant. Results:  In Group A, complete clinical cure/efficacy was noted in 28.3% and 94.7% patients at day 14 and 28, respectively. In Group B, complete clinical cure/efficacy was noted in 34.0% and 94.4% patients at day 14 p= 0.338) and 28 (p=0.817), respectively. Over all 22 patients (20.7%) showed relapse. Visual disturbance in the form of altered perception of light after first dose was the most common side effect noted. Conclusion:  Oral voriconazole at a dosage of 200 mg once daily is comparable in efficacy and safety to 200 mg twice daily regimen but is more cost effective in treatment of resistant tinea corporis and tinea cruris.