What is the recommended treatment for onychomycosis of the toenail?

The recommended treatment for onychomycosis of the toenail is terbinafine taken daily for three months. Terbinafine is an antifungal medication specifically indicated for the treatment of fungal infections of the nails. Its efficacy is due to its ability to accumulate in the nail tissue and effectively eradicate the fungal organisms causing the infection.

The duration of three months is clinically supported as it allows sufficient time for the medication to work through the growth cycles of the toenails, which can be slower than those of fingernails. By the time the toenail has fully grown out, which can take several months, the treatment should have cleared the infection from the nail bed.

In contrast, fluconazole, while useful for various fungal infections, has not been shown to be as effective as terbinafine for onychomycosis when considering the specific pharmacokinetics and the duration required for optimal results. Griseofulvin is generally not a first-line treatment for onychomycosis, especially due to its shorter course and less effectiveness for toenail infections. Topical treatments like clotrimazole do not penetrate the nail adequately to treat onychomycosis effectively, making them less suitable for this condition, especially when compared