The Boosted Oral Antifungal Treatment for Onychomycosis beyond the Regular Itraconazole Pulse Dosing Regimen

BACKGROUND: Modern treatments for onychomycosis do not yield an ideal cure rate. OBJECTIVE: The boosted oral antifungal treatment (BOAT) is introduced as a novel approach improving the efficacy of oral treatment with the itraconazole pulse dosing regimen. METHOD: The BOAT design targets resting fungal cells in order to produce sensitive hyphae which are less refractory to antifungals. This is performed by securing a piece of a Sabouraud's agar slide onto the affected nail in alternance with oral intake of itraconazole. RESULTS: The present comparative intraindividual trial suggests that BOAT improves the mycological cure rate compared to the regular treatment. CONCLUSION: BOAT is a promising simple and cheap combined therapy for onychomycosis. However, the present pilot study calls for further clinical investigations.