# Sensitivity of Dermatophytes to Terbinafine: World Experience and Recent Findings from Kazakhstan

## TL;DR

This study examines how sensitive dermatophytes from Kazakhstan are to terbinafine, finding that most are still responsive, though some Trichophyton species show resistance.

## Contribution

The study provides the first data on terbinafine sensitivity of dermatophyte isolates from Kazakhstan and highlights emerging resistance in Trichophyton species.

## Key findings

- All Microsporum canis isolates were 100% sensitive to terbinafine.
- 12.1% of Trichophyton isolates showed resistance to terbinafine.
- Resistant isolates included T. indotineae, T. interdigitale, and T. mentagrophytes.

## Abstract

Background/Objectives: This article describes the results of an analysis of the sensitivity of dermatophytosis pathogens to terbinafine, conducted by the authors based on a review of available scientific publications and data from their own research. Currently, no information is available on the sensitivity of Kazakh isolates obtained from patients at dermatological clinics. The aim of this study was to compile data on the resistance of dermatophytes to terbinafine over the past decade worldwide and investigate the sensitivity of dermatophyte isolates collected from patients in Astana, Kazakhstan, to terbinafine. Methods: A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, utilizing the Pubmed and Cochrane Library databases with specific keywords. The sensitivity of the dermatophytes to terbinafine was assessed using EUCAST E.Def 11.0 method. Results: Screening of terbinafine susceptibility among Kazakh clinical isolates revealed that all Microsporum canis strains (57/57, 100%) were sensitive to the drug. Among 33 Trichophyton spp. isolates, 4 (12.1%) demonstrated resistance to terbinafine, with MIC values ranging from 0.125 to 1.5 µg/mL. The resistant isolates belonged to the species T. indotineae, T. interdigitale, and T. mentagrophytes. Conclusions: Terbinafine remains highly effective against Microsporum canis in Kazakhstan, while a small proportion of Trichophyton isolates show resistance. Continuous monitoring of dermatophyte susceptibility is warranted to guide effective treatment.