{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:45:19Z","timestamp":1790729119040,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,10,9]],"date-time":"2021-10-09T00:00:00Z","timestamp":1633737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>With rising resistance to terbinafine, and consistently high MICs to fluconazole and griseofulvin, itraconazole is being increasingly used as a first line drug for tinea corporis\/cruris. However, inadequate clinical responses are often seen with it in spite of <jats:italic>in vitro<\/jats:italic> susceptibility. This is possibly related to a variable pharmacokinetic profile of itraconazole. The drug serum levels associated with the therapeutic outcome have not been defined in dermatophytic infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty treatment na\u00efve patients with tinea corporis\/cruris were randomised to one of the three dose groups (100, 200 and 400\u00a0mg\/day) of itraconazole. The drug serum levels of 21 of these patients were obtained after 2\u00a0weeks of treatment and correlated with the final clinical outcome and <jats:italic>in vitro<\/jats:italic> antifungal susceptibility data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>Trichophyton indotineae<\/jats:italic> was identified by sequencing of ITS region of rDNA and <jats:italic>TEF1\u03b1<\/jats:italic>. All isolates were sensitive to itraconazole (Minimum Inhibitory Concentration (MICs) range: 0.06\u20130.5\u00a0\u00b5g\/ml), while MICs to terbinafine were uniformly high (range 8\u201332\u00a0\u00b5g\/ml). Thirty\u2010seven patients (92.5%) achieved complete cure, while three failed treatment. Serum levels achieved with 400\u00a0mg\/day were significantly higher than levels with 100 or 200\u00a0mg dose. All patients with itraconazole serum levels of &gt;0.2\u00a0\u00b5g\/ml were cured, while two out of the 10 patients with serum levels &lt;0.2\u00a0\u00b5g\/ml failed treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Therapeutic failures are uncommon with itraconazole, and the prevalent strain in India has low itraconazole MICs. Treatment failure is likely with itraconazole serum levels of &lt;0.2\u00a0\u00b5g\/ml, while levels &gt;0.2\u00a0\u00b5g\/ml are consistently associated with a positive therapeutic outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13367","type":"journal-article","created":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T08:35:07Z","timestamp":1631867707000},"page":"1480-1488","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Predicting a therapeutic cut\u2010off serum level of itraconazole in recalcitrant tinea corporis and cruris\u2014A prospective trial"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7020-7777","authenticated-orcid":false,"given":"Ananta","family":"Khurana","sequence":"first","affiliation":[{"name":"Department of Dermatology Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences New Delhi 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