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© All-Russian National Academy of Mycology,
2001
© A. Sergeev, 1999-2001
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SCIO
and nail kinetics |
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While
designing SCIO we have tried to adapt it values to real mean
outgrowth times of the human nail. That's why SCIO value may
help to expect treatment duration. Imagine SCIO of some affected
nail is 12. That means that outgrowth time of affected part
of the nail is about 12 months. And that means that MIC of some
antifungal should remain in the nail for 12 months, to make
fungus not viable/not growing until affected part regrows. Knowing
nail kinetics of modern antifungals one may predict the neccessary
treatment duration (e.g. one or two extra months when SCIO is
16). With antifungals that don't accumulate in the nail, such
as fluconasole, SCIO is direct indication of needed duration.
E.g. SCIO=9 means 9 months of fluconasole 150 mg once weekly.
...we have went even further when proposed sequential combination
therapy. It means: systemic therapy until SCIO returns to values
indicating topical treatment. E.g. in SCIO=18 terbinafine for
12 weeks, and when SCIO reduces to 6, continue with topical
antifungal, e.g. amorolfine nail lacquer, for 6 months. |
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Anything
else? |
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