A randomized comparison of 4 weeks of terbinafine vs. 8 weeks of griseofulvin for the treatment of tinea capitis.
BACKGROUND
Tinea capitis is a common childhood infection that has recently become more frequent in urban areas in Europe and the U.S.A. The current licensed treatment in children is griseofulvin 10 mg kg(-1) daily, which is usually given for 6--8 weeks.


OBJECTIVE
To compare this treatment with a 4-week course of oral terbinafine.


METHODS
Terbinafine was given at the following doses: in children weighing < 20 kg, 62.5 mg daily; 20--40 kg, 125 mg daily; > 40 kg, 250 mg daily. Two hundred and ten children aged 2--16 years, with mycologically confirmed tinea capitis, were randomized to 4 weeks treatment with terbinafine or 8 weeks with griseofulvin, and followed for a total of 24 weeks to determine the difference between treatments with respect to short- and long-term efficacy and tolerability.


RESULTS
One hundred and forty-seven patients were evaluable (terbinafine 77, griseofulvin 70). Although the 4-week course of terbinafine resulted in a trend to more rapid clearance of tinea capitis, there were no statistically significant differences between the two drugs in terms of overall outcome or tolerability, apart from in a subgroup of patients with Trichophyton infections, and weighing > 20 kg, who responded better to terbinafine than to griseofulvin at 4 weeks. By contrast, there was a better response to griseofulvin than to terbinafine in patients with Microsporum audouinii infections.


CONCLUSIONS
Overall, the study showed that 4 weeks of treatment with oral terbinafine has similar efficacy to 8 weeks of treatment with griseofulvin for the management of tinea capitis in children.
Department of Dermatology, King's College Hospital, London SE5 9RS, UK.
L C
LC
Fuller
C H
CH
Smith
R
R
Cerio
R A
RA
Marsden
G
G
Midgley
A L
AL
Beard
E M
EM
Higgins
R J
RJ
Hay
D000293:Adolescent; D000886:Anthropometry; D000935:Antifungal Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006118:Griseofulvin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009281:Naphthalenes / Q000627:therapeutic use*; D000077291:Terbinafine; D014006:Tinea Capitis / Q000188:drug therapy*; D016896:Treatment Outcome
D000935:Antifungal Agents; D009281:Naphthalenes; D006118:Griseofulvin; D000077291:Terbinafine