Antifungal Drug Resistance of Dermatophytes Causing Superficial Fungal Infections

Background: Superficial fungal infections (SFI) are common skin diseases that were largely simple to treat. However, due to increasing antimicrobial resistance (AMR) of dermatophytes to antifungal drugs, treatment of SFI has become difficult. This study aims to analyze the AMR of dermatophytes and to correlate with the clinical response of antifungal drugs. Methods: A cross‑sectional evaluation was undertaken of 570 consecutive patients with SFI such as tinea corporis, tinea cruris, tinea faciei, and tinea pedis, who were treated with any of the oral antifungal drugs fluconazole, itraconazole and terbinafine. Clinical response was taken within 1 month of stopping the therapy. Microscopic as well as culture and antimicrobial sensitivity analysis were done to characterize and determine the susceptibility of dermatophytes to antifungal drugs aforementioned. Results: Among the 570 patients with SFI, the ratio of male (n=360, 63.16%) to female (n=210, 36.84%) was 1.7:1. The common age group affected by SFI was 31-40 years (27.71%, n=158). The tinea corporis was the most predominant (51.05%) followed by tinea cruris (13.68%). Clinical response analysis showed that the percentage of relapse of SFI after completion of treatment with fluconazole, itraconazole and terbinafine was about 55, 45 and 19, respectively. Culture and antimicrobial sensitivity analysis revealed that the percentage of resistance of dermatophytes from patients of SFI to fluconazole, itraconozole and terbinafine was approximately 70, 55 and 20, respectively. Conclusion: Results reported herein support the notion that the antifungal resistance is evolving in dermatophytes causing SFI, and about 20% dermatophytes are multidrug resistant.