Synergistic effects of tetrandrine on the antifungal activity of topical
ketoconazole cream in the treatment of dermatophytoses: a clinical trial.
Author(s): Shi JP, Zhang H, Zhang ZD, Zhang GH, Gao AL, Xiang SB.
Affiliation(s): Department of Dermatology, the First Affiliated Hospital, Jinan University,
Guangzhou 510632, China.
Publication date & source: 2011, Chin J Integr Med. , 17(7):499-504
OBJECTIVE: To evaluate the synergistic effects of tetrandrine (TET) on the
antifungal activity of topical ketoconazole (KCZ) in the treatment of
dermatophytoses.
METHODS: The minimum inhibitory concentrations (MICs) for KCZ and combined KCZ
and TET were compared in vitro. A randomized, double-blind trial was conducted
among 97 patients with dermatophytoses who were assigned to 3 groups and
received: treatment with combination of 2% KZC and 2% TET cream (KCZ + TET
group), or only 2% KZC cream (KCZ group), or 2% TET cream (TET group). Patients
with tinea corporis and/or tinea cruris were treated for 2 weeks, separately. The
patients with tinea pedis and/or tinea manuum were treated for 4 weeks.
RESULTS: Compared with KZC alone, combined use of KZC and TET showed lower MICs
against clinical isolates of dermatophytes (P<0.05 for all). In the patients with
tinea corporis and/or tinea cruris, the rates of overall cure (clinical cure plus
mycologic clearance) were 81.25% vs. 33.33% for combined treatment and KZC
monotherapy, respectively, after 4 weeks. All clinical indices were significantly
different between the combination therapy and only KCZ therapy groups (P<0.05).
Among the patients with tinea pedis and/or tinea manuum after 4 weeks treatment,
the overall cure rates in the KCZ + TET group and KCZ group were 75.00% vs.
40.00%, respectively. In the KCZ + TET group, all the clinical indices were
significantly better than those in the KCZ group and TET group (P<0.05). The
rates of overall efficacy in the TET group were all zero. No local skin redness
or itching was observed during TET treatment. No clinically significant changes
were found in post-treatment routine blood, urine, or stool tests, ECG, or tests
for liver and kidney function; no serious adverse events occurred.
CONCLUSION: TET synergistically enhanced the clinical efficacy of topical KZC
cream in the treatment of dermatophytoses.
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