Combination of itraconazole and terbinafine in treating sporotrichosis and their in vitro antifungal activities against Sporothrix schenckii

Objective To evaluate the efficacy of the combination of itraconazole and terbinafine in treating sporotrichosis and against Sporothrix schenckii growing in both mycelial and yeast phases.Methods The combination of itraconazole(200 mg/d) and terbinafine(250 mg/d) was applied in the treatment of sporotrichosis.In vitro effects against Sporothrix schenckii in two growth phases were evaluated by checker-board method,and fractional inhibitory concentration(FIC) index was caculated to determine whether the interaction was synergistic,indifference,or antagonistic.Results Three patients failed in itraconazole therapy were cured with the combination of itraconazole and terbinafine.Synergistic interactions of itraconazole and terbinafine against Sporothrix schenckii in mycelial form and in yeast form,were observed to be 75% and 70% respectively(P=0.50).Conclusions The combination of itraconazole and terbinafine is efficient and safe in treating sporotrichosis with perfect synergy.