Efficacy and Safety of Topical Antifungals in the Treatment of Dermatomycosis

A Systematic Review

I. Rotta; A. Sanchez; P.R. Gonçalves; M.F. Otuki; C.J. Correr


The British Journal of Dermatology. 2012;166(5):927-933. 

In This Article


Systematic Review of the Literature

Of the 4443 articles initially identified, 4183 were excluded after title/abstract review and another 59 after full-text analysis because they did not meet the inclusion criteria. In addition, 97 articles were excluded for being duplicates. Thus, 104 RCTs satisfied the inclusion criteria and were included in the meta-analysis. As some articles reported more than one study, we included a total of 135 studies. Of these, 73 compared antifungals with placebo and 62 compared antifungals with each other (Fig. 1). The studies included 15 795 participants, of which 66% were men, and the weighted mean age was 38·4 years. We found 55 of the 120 possible comparisons among the 16 drugs evaluated (Fig. 2). For details about the characteristics of the studies, see Appendix S3 (see Supporting information).

Figure 1.

Flowchart of the selection of randomized controlled trials included in the systematic review.

Figure 2.

Network of eligible comparisons between topical antifungals and placebo and among them for the treatment of dermatomycosis. This network represents all relationships for both efficacy outcomes evaluated. The width of the line connecting two elements is proportional to the number of comparisons between them. Through the network, it is clear that there is an absence of several head to head comparisons, with only 55 found among the 120 possible comparisons.


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