Fluconazole vs. Itraconazole in the treatment of tinea versicolor

Ninety patients with tinea versicolor were randomly assigned to treatment with either a single 450‐mg dose of fluconazole, two 300‐mg doses of fluconazole given 1 week apart, or itraconazole 200 mg daily for 7 days. At the end of treatment, the cure rate for itraconazole (20%) was significantly higher (P = 0.024) than that for fluconazole 450 mg (0%). When cure plus improvement was considered, response rates among the three treatment groups were comparable (97, 100, and 97% for fluconazole 450 mg, fluconazole 300 mg, and itraconazole, respectively). Failure rates at the end of treatment were low (0–3%). Clinical response rates achieved at the end of treatment generally were maintained at 1 month, but tended to decrease at 2 months. Eradication at the end of treatment was not significantly different among the treatment groups (17, 33, and 38% for fluconazole 450 mg, fluconazole 300 mg, and itraconazole, respectively). At 1 month, the eradication rate was significantly higher (P = 0.012) for the two‐dose than the single‐dose fluconazole treatment group (97 and 70%, respectively). At 2 months, reinfection rates were 21, 20, and 4% for fluconazole 450 mg, fluconazole 300 mg, and itraconazole, respectively. No clinical adverse events occured, and no patients were withdrawn for laboratory abnormalities.