In Vitro Effect of Terbinafine on Human Leukocyte Chemotaxis and Chemiluminescence/In vitro-Effekt von Terbinafin auf die Chemotaxis und Chemilumineszenz von Leukozyten des Menschen

Terbinafine induces the PMNL priming effect and enhances in vitro PMNL fungicidal activity against Candida albicans blastospores

Terbinafine, a new antifungal drug of the allylamine category, has been shown not to interfere with some polymorphonuclear leucocyte (PMNL) functions such as chemotaxis and chemiluminescence. The aim of the present study was to elucidate the effects of terbinafine on PMNL respiratory burst activation and killing of Candida albicans blastospores by PMNLs at the biochemical and ultrastructural level by means of scanning electron microscopy (SEM). Terbinafine is shown to enhance the respiratory burst and superoxide anion release in human PMNLs stimulated by phorbol esters or chemotactic peptides, and to have a priming effect on PMNL functions. Moreover, in our experiments we found that terbinafine does not interfere with PMNL killing of C. albicans blastospores but, in fact, at the concentration found in tissues after oral administration, slightly increases it. As PMNLs play a key role in the early stages of fungal infections we suggest that in vivo terbinafine induces priming of PMNLs, and that this effect is related to enhanced candidacidal activity independent of direct drug damage to fungal particles.

A clinical trial of topical terbinafine (a new allylamine antifungal) in the treatment of tinea pedis

Twenty-three patients were enrolled in a randomized, double-blind trial of terbinafine 1% cream compared with placebo vehicle in the treatment of tinea pedis. Of the 20 patients who were evaluated for efficacy, 10 received terbinafine and 10 received placebo. Except for the terbinafine-treated patients being an average of 11 years older than the patients receiving placebo and the median duration of disease being 6 weeks longer in the placebo group, the two groups were demographically and clinically similar. Results of mycologic tests and clinical findings showed terbinafine to be significantly more effective than placebo in the treatment of tinea pedis. Significantly more terbinafine-treated patients than placebo-treated patients showed conversion to negative culture and microscopy at end of therapy and a significant reduction in scored signs and symptoms. Overall efficacy at follow-up (combined mycologic and clinical findings) was also significantly greater in the terbinafine group (78%) than in the placebo group (zero) (p less than 0.001). Unexplained elevation of liver function test results was noted in three placebo-treated patients and in one terbinafine-treated patient, but these changes were not considered clinically relevant or drug related.