Dermatophyte Infection - Nail

NHSL Antimicrobial Guidelines
NHS Lanarkshire

Dermatophyte infection - nail

CKS: Fungal nail infection

Take nail clippings: start therapy only if infection is confirmed by laboratory.

Oral terbinafine is more effective than oral azole.

Liver reactions rare with oral antifungals.

If candida or non-dermatophyte infection confirmed, use oral itraconazole.

For children, seek specialist advice.

Drug details

Drug

First line:
Terbinafine

Dosage

250mg OD

Duration

Fingers: 6-12 weeks

Toes: 3-6 months

Drug

Second Line:
Itraconazole

Check for drug interactions. Seek advice.

Dosage

200mg BD

Duration

7 days monthly

Fingers: 2 courses

Toes: 3 courses

Editorial Information

Last reviewed: 22/03/2021

Next review date: 22/03/2024

Author(s): NHS Lanarkshire Antimicrobial Management Committee, Dr Dundas, Dr Hylands, S McCormick.

Approved By: AMC; ADTC

Reviewer name(s): NHS Lanarkshire Antimicrobial Management Committee.