Oral antifungals effective for toenail onychomycosis

There was high-quality evidence that oral azole and terbinafine treatments were more effective for achieving mycological cure and clinical cure for onychomycosis, when compared with placebo.

When compared directly, terbinafine was probably more effective than azole and likely not to be associated with excess adverse events (both moderate-quality evidence).

Low-certainty evidence showed griseofulvin to be less effective than terbinafine in terms of both mycological and clinical cure, while griseofulvin and azole probably had similar efficacy (moderate-quality evidence).

Griseofulvin was associated with more adverse reactions than azoles (moderate-quality evidence) and terbinafine (low-quality evidence).

No study addressed quality of life.

The evidence in this review applied for treatments of at least 12 weeks in duration.