{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T15:28:32Z","timestamp":1790436512748,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T00:00:00Z","timestamp":1709078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009754","name":"Galderma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009754","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Onychomycoses are difficult\u2010to\u2010treat fungal infections with high relapse rates. Combining oral and topical antifungal drugs is associated with higher success rates. Additive or synergistic modes of action are expected to enhance treatment success rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Investigation of the combined effects of antifungal drugs in\u00a0vitro with different modes of action and application on clinical isolates from mycotic nails.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Isolates of <jats:italic>Trichophyton rubrum, Trichophyton interdigitale<\/jats:italic> and <jats:italic>Scopulariopsis brevicaulis<\/jats:italic> were collected from infected toenail specimens of patients with onychomycosis. Susceptibility testing was performed in 96\u2010well polystyrene plates using a standard stepwise microdilution protocol. Additive or synergistic activity at varying concentrations was investigated by the checkerboard method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Combining terbinafine with amorolfine tended to be more effective than terbinafine in conjunction with ciclopirox. In most combinations, additive effects were observed. Synergy was detected in combinations with involving amorolfine in <jats:italic>S. brevicaulis<\/jats:italic>. These additive and synergistic interactions indicate that combined therapy with topical amorolfine and oral terbinafine is justified. Sublimation of amorolfine (and terbinafine) may enhance the penetration in and through the nail plate, and support treatment efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These in\u00a0vitro results support the notion that combining oral terbinafine and topical amorolfine is beneficial to patients with onychomycosis, particularly if the pathogen is a non\u2010dermatophyte fungus such as <jats:italic>S. brevicaulis<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13710","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T08:08:55Z","timestamp":1709107735000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Activity of amorolfine or ciclopirox in combination with terbinafine against pathogenic fungi in onychomycosis\u2014Results of an in\u00a0vitro investigation"],"prefix":"10.1111","volume":"67","author":[{"given":"Martin","family":"Schaller","sequence":"first","affiliation":[{"name":"Department of Dermatology Eberhard\u2010Karls University Hospital  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Dermatology Eberhard\u2010Karls University Hospital  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Schafiq","family":"Nabhani","sequence":"additional","affiliation":[{"name":"Medical and Regulatory Department, Galderma Laboratorium GmbH  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Odon","sequence":"additional","affiliation":[{"name":"Department of Dermatology Eberhard\u2010Karls University Hospital  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Riel","sequence":"additional","affiliation":[{"name":"Department of Dermatology Eberhard\u2010Karls University Hospital  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"J\u00e4ckel","sequence":"additional","affiliation":[{"name":"Medical and Regulatory Department, Galderma Laboratorium GmbH  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"28","article-title":"Onychomykose \u2010 Aktuelle Daten zu Epidemiologie, Erregerspektrum, Risikofaktoren sowie Beeinflussung der Lebensqualit\u00e4t","volume":"97","author":"Abeck D","year":"2000","journal-title":"Deutsches \u00c4rzteblatt"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2009.03487.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1610-0387.2006.05877.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myu039"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.13251"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2000.109072"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.1992.tb00270.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1988.tb40417.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-198529040-00002"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.10.4817-4819.2003"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/idoj.IDOJ_146_19"},{"key":"e_1_2_10_13_1","unstructured":"SchallerM NabhaniS WalkerB J\u00e4ckelA.An in\u2010vitro study of the efficacy of a combination of amorolfine 5% with terbinafine against dermatophytes and non\u2010dermatophyte moulds. Poster Presented at Scientific Conference of Deutschsprachige Mykologische Gesellschaft;2019."},{"key":"e_1_2_10_14_1","unstructured":"SchallerM NabhaniS WalkerB J\u00e4ckelA.In vitro synergistic effects of amorolfine and ciclopirox in combination with terbinafine onScopolariopsis brevicaulis. 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