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Fungal skin infection - body and groin - Management
Basis for recommendation
Recommended treatments
- There is evidence that oral griseofulvin, terbinafine, and itraconazole are effective for the treatment of fungal infections of the body and groin, but CKS found insufficient evidence to recommend one oral antifungal in preference to another.
- The information to guide the choice of oral antifungal was largely based on expert opinion and manufacturers' information [Gupta et al, 2004; Chemidex Pharma Ltd., 2005; Aronson, 2006; HPA, 2007; Andrews and Burns, 2008; BNF for Children, 2008; ABPI Medicines Compendium, 2009; BNF 57, 2009].
Treatments not recommended
- Oral fluconazole: there is evidence that fluconazole is effective for treating fungal infections of the body and groin. However, there is more evidence to support the use of griseofulvin, terbinafine, and itraconazole.
- Oral ketoconazole: this should only be initiated by a physician who is experienced in the management of fungal infections because of the risk of serious hepatotoxicity. Oral ketoconazole should only be prescribed for the treatment of dermatophytosis that cannot be treated topically because of the site, extent of the lesion, or deep infection of the skin, in people resistant to or intolerant of both fluconazole and itraconazole [MHRA, 2008].
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