A Comparison between the Efficacies of Fluconazole and Ketoconazole in the Treatment of Tinea Versicolor

Introduction: Both fluconazole as well as ketoconazole are Azole antifungal agents. Ketoconazole has two Nitrogen atoms in its azole ring and fluconazole has three N-atoms. Both the drugs work by inhibiting the cytochrome P450 dependent enzyme and are used widely in the treatment arena of Dermatology. Tinea versicolor (TV) or pityriasis versicolor is caused by a type of yeast that naturally lives on human skin. Aim of the study: The aim of this study was to compare the efficacies of fluconazole and ketoconazole in treating tinea versicolor. Methods: This comparative prospective study was conducted in the Department of Dermatology of Cumilla Medical College Hospital, Cumilla, Bangladesh during the period from January 2018 to December 2018. In total 60 patients with tinea versicolor, age around 15–55 years, were finalized as the study population who has continued up to the end of the full tenure of this intervention. The patients were randomly divided into equal two groups. Patients of Group I (n=30) received 300 mg fluconazole as a single dose and repeated weekly for 2 weeks and patients of Group II (n=30) received 400 mg ketoconazole as a single dose and repeated weekly for 2 weeks. Diagnosis of TV was made clinically and by direct KOH preparation. Result: After completing 1 (One week) treatment we got 60% mycological cure rate in Group I patients who were treated by fluconazole. On the other hand this rate was 56.67% which was some less than that of Group II and these patients were treated by Ketoconazole. On the other hand, after completing 2 (Two weeks) treatment we got 93.33% mycological cure rate in Group I patients who were treated by fluconazole. On the other hand this rate was 86.67% which was some less than that of Group II and these patients were treated by Ketoconazole. Conclusion: Although in our study we found some superiority of fluconazole regarding efficacy over ketoconazole in treating tinea versicolor but the ratio was not remarkable. Both the antifungal agents of Azole group were well tolerated.