{"id":51,"date":"2012-02-08T14:49:19","date_gmt":"2012-02-08T22:49:19","guid":{"rendered":"https:\/\/phcprimarycare.org\/?p=51"},"modified":"2014-02-19T13:45:45","modified_gmt":"2014-02-19T21:45:45","slug":"cost-effective-treatment-for-onychomycosis","status":"publish","type":"post","link":"https:\/\/phcprimarycare.org\/?p=51","title":{"rendered":"Cost-effective treatment for onychomycosis"},"content":{"rendered":"<p>Onychomycosis is a very common condition leading patients to seek advice from their primary care clinician.<\/p>\n<p>Systemic treatment is the most effective: oral terbenifine is off patent and very <!--more-->inexpensive ($4 per month at Walmart). Its cure rate is 76%. I recommend sending a nail clipping for PAS stain if there is any doubt of the diagnosis. Education about the length of treatment is important. There is a chance of hepatotoxicity, and a few drug interactions to keep in mind as well.<\/p>\n<p>For topical treatment, Vicks VapoRub\u00ae has a cure rate of 30% in this FP residency study: <a href=\"https:\/\/mail1.partnershiphp.org\/owa\/redir.aspx?C=a1b302f05d2b4076b4c009c407e3febc&amp;URL=http%3a%2f%2fwww.ncbi.nlm.nih.gov%2fpubmed%2f21209346\" target=\"_blank\">http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21209346<\/a><\/p>\n<p>There was visual improvement in the nails in 70% of patients.<\/p>\n<p>For comparison, this study of ciclopirox nail lacquer (<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11051136\">http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11051136<\/a>) also shows a 30% cure rate.<\/p>\n<p>Vicks VaboRub\u00ae is much cheaper (and over the counter) compared to ciclopirox. I recommend\u00a0Vicks VapoRub\u00ae\u00a0when you and your patient decide topical treatment is the best option.<\/p>\n<p>Robert Moore, MD, MPH<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Onychomycosis is a very common condition leading patients to seek advice from their primary care clinician. Systemic treatment is the most effective: oral terbenifine is off patent and very<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"class_list":["post-51","post","type-post","status-publish","format-standard","hentry","category-formulary-pharmacy-issues"],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/posts\/51","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=51"}],"version-history":[{"count":5,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/posts\/51\/revisions"}],"predecessor-version":[{"id":824,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=\/wp\/v2\/posts\/51\/revisions\/824"}],"wp:attachment":[{"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=51"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=51"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/phcprimarycare.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=51"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}