Comparative Analysis of Lists of Antifungal Preparations for Onychomycosis Treatment In British and Ukrainian National Formularies

OBJECTIVES: Topical antifungals are used to treat fungal nail diseases (onychomycosis). The research aim was to compare antifungal drugs for topical treatment of onychomycosis listed in British National Formulary 70 (BNF, 2016) and Ukrainian National Formulary 8thedition (UNF, 2016). METHODS: data and comparative analysis of preparations included in the formularies. RESULTS: Topical antifungal drugs for onychomycosis are represented in the chapters "Fungal skin infections" of BNF and "Topical antifungal preparations" of UNEThese preparations are mostly recommended for skin, but some of them may be also used for nails. It must be noted that analysis of antifungals listed in UNF was a little complicated due to the lack of clear delimitations in the indications. BNF recommends 10 preparations to treat nails in different dosage forms: 1 powder, 1 spray, 2 creams, 6 lacquers and paints. UNF recommends only 8 preparations, most of them are semi-solids (87,5%: gels - 37,5%, creams - 50%) and only 1 cutaneous solution (12,5%). Imidazoles are the widest group of the analyzed preparations (50% in BNF, 100% in UNF). The preparations, except of lacquers/paints, are generally recommended for transungual application that involves nail removal. The distinct difference in the lists is absence of preparations specially developed for nails in UNF; however, antifungal nail lacquers have been registered in Ukraine. Conversely, BNF recommends 6 such preparations: paint with tioconazole, lacquers with amorolfine (4) and paint with boric, salicylic and tannic acids. CONCLUSIONS: The obtained results revealed that topical antifungals specially developed for nails are not included into UNF, whereas BNF does recommend them. There is a need for review of topical antifungal preparations and inclusion of lacquers/paints into UNF for good treatment.