12-month clinical trial of bioencapsulated terbinafine yielded inconsistent resolution for the treatment of Emydomyces testavorans in the Blanding's turtle (Emydoidea blandingii).

Oral bioencapsulated terbinafine at 30 mg/kg every 48 hours failed to resolve Emydomyces testavorans infection in Blanding's turtles.

This 12-month experimental study evaluated oral bioencapsulated terbinafine (30 mg/kg every 48 hours) for treating Emydomyces testavorans (shell fungal disease) in 13 naturally infected Blanding's turtles (Emydoidea blandingii) housed in a quarantine facility. Terbinafine was delivered via bioencapsulation in earthworms to facilitate voluntary ingestion. Disease resolution was monitored using quantitative PCR of combined oral, cloacal, and carapace/plastron swabs, while plasma drug concentrations were measured at months 3, 6, 9, and 12. No turtle achieved consistent PCR-negative status for E. testavorans after the full treatment course. Plasma terbinafine concentrations were highly variable and inconsistently exceeded the minimum inhibitory concentration (MIC) for E. testavorans. Trough concentrations (months 3 and 6) were markedly lower (medians 18 and 36 ng/mL) compared to peak concentrations (months 9 and 12; medians 163 and 100 ng/mL). No significant correlation was identified between plasma drug concentrations and quantitative PCR target copy numbers. The authors conclude that this bioencapsulated oral terbinafine protocol is insufficient as monotherapy for E. testavorans and emphasize the need for alternative dosing strategies, improved drug delivery methods, or multimodal treatment approaches. Given E. testavorans is an emerging conservation concern for chelonian species globally, further pharmacokinetic and pharmacodynamic investigations are critically needed.

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