Prevention and treatment strategy for onychomycosis: a guide for physicians and pharmacists

Abstract

This article reviews current strategies for the treatment and prevention of onychomycosis, a chronic fungal nail infection, the global prevalence of which reaches 20% or higher in high-risk groups (the elderly, patients with diabetes mellitus, and the immunocompromised). The authors examine the etiological profile (dominated by Trichophyton rubrum), risk factors, and key mechanisms of resistance, including the spread of Trichophyton indotineae. Strategies for topical, systemic, and combination therapies are analyzed in detail, alongside criteria for drug selection based on the clinical form of the disease and the patient's comorbid conditions. Particular attention is paid to essential components of successful prevention and treatment, such as footwear disinfection and non-pharmacological methods like laser therapy, photodynamic therapy, surgical nail plate removal, medical instrument-based pedicures, etc. The importance of a comprehensive, personalized approach and laboratory monitoring of cure status to ensure lasting results and prevent recurrence is emphasized.