Rarely Discussed Topics in Onychomycosis: Antifungal Resistance, Microbiology, and the Evidence for OTC Products
Warren S Joseph, DPM, FIDSA
Consultant, Lower Extremity Infectious Diseases
Adjunct Clinical Professor
Arizona College of Podiatric Medicine
Onychomycosis has been a consistent topic at podiatric and dermatology conferences since the first truly effective FDA approved oral antifungal, terbinafine, was approved in the late 1990s. Therapeutically, the major change in the intervening 20 years has been the approvals of the prescription topical therapies; ciclopirox lacquer, effinaconazole solution and tavaborole solution.
Dr. Joseph will present topics that traditionally have not been discussed in great detail in the majority of onychomycosis presentations. These include the emergence of antifungal resistance, primarily to the previous “Gold Standard” antifungal terbinafine, some unique aspects of the molecular diagnosis of fungal infections, and, finally, examine the evidence for the use of over-the-counter topical antifungal products that are available at local pharmacies and being dispense in podiatrist’s offices.
- Recognize that increasing rates of resistance to antifungal drugs, such as terbinafine, may begin to limit their clinical usefulness.
- Understand the microbiology of antifungal resistance and how it may be minimized with appropriate therapy
- Appreciate the strict standards set by the FDA to approve new antifungal agents for the treatment of onychomycosis
- Identify the clinical evidence in the literature to support the use of the marketed OTC agents
PRESENT e-Learning Systems is approved by the Council on Podiatric Medical Education as a provider of continuing education in podiatric medicine. PRESENT e-Learning Systems has approved this activity for a maximum of 1 continuing education contact hour.
AffinityCE designates this live educational activity for AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity. A maximum of 1 AMA PRA Category 1 CreditTM will be awarded.
Nurses: CE is provided for this program through collaboration between PRESENT e-Learning Systems and AffinityCE. AffinityCE is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC). This activity provides 1 contact hour of nurse CE credit.