The tinea epidemic is more than 5 years old.Difficulties in treatment arises due to:o Rapidly progressive disease that spreads easily amongst contactso Unusual, highly symptomatic manifestationso Poor response to recommend treatmentso Repeated episodes in spite of apparently successful treatment.The need for new guidelines is evident; however, guidelines are only as good as; clear definition of the clinical problem in all its aspects, the rigor of process followed for the...
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o Rapidly progressive disease that spreads easily amongst contacts
o Unusual, highly symptomatic manifestations
o Poor response to recommend treatments
o Repeated episodes in spite of apparently successful treatment.
The need for new guidelines is evident; however, guidelines are only as good as; clear definition of the clinical problem in all its aspects, the rigor of process followed for their generation and the quality of data that is used as their basis.
Issuing different guidelines for a poor drug quality driven epidemic would be pointless and may be even dangerous.
Guideline development in India was undergoing transition toward adoption of systematic, transparent and evidence-based approaches but several barriers in the form of attitudes towards use of evidence, lack of methodological capacity, inadequate governance structure and funding exist.
Treatment guidelines in the absence of MIC breakpoints:
o There are no defined criteria for labeling dermatophyte strains sensitive or resistant
o Clinical-lab correlation for antifungal sensitivity studies remains relatively poor
o A recent expert consensus recommended terbinafine or itraconazole for the initial treatment of tinea corporis.
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