title: Comparative evaluation of griseofulvin, terbinafine and fluconazole in the treatment of tinea capitis.
abstract: Tinea capitis (TC) is a common childhood fungal infection which, if untreated, can cause long-term scarring. A number of antifungal drugs with proven efficacy are available for the treatment of TC. However, varying dosage schedules, changes in epidemiology, and rising drug resistance are factors that hamper treatment in some cases. A prospective, non-blinded, cross-sectional study of three commonly used drugs (terbinafine, griseofulvin, and fluconazole) was undertaken in children aged ≤12 years, presenting to a pediatric superspecialty hospital. The comparative efficacies of these three drugs were evaluated. A total of 75 patients (25 in each treatment group) who completed the designated treatment protocol were included in the final analysis. Of these, 60% had non-inflammatory TC and 56% had an ectothrix pattern on hair microscopy. Trichophyton violaceum was the most commonly isolated fungus. Cure rates of 96%, 88%, and 84% were achieved with griseofulvin, terbinafine, and fluconazole, respectively. Overall, seven patients required prolonged therapy. No side effects to therapy were seen. Griseofulvin remains the drug of choice in the treatment of TC. Terbinafine was the second best agent and offered the advantage of a shorter course of therapy. Fluconazole had comparatively low cure rates but was easier to administer than the other two medications.
authors.affiliation: Department of Dermatology, Chacha Nehru Bal Chikitsalaya Pediatric Hospital, Delhi, India. chandergroverkubba@rediffmail.com
authors.forename: Chander
authors.initials: C
authors.lastname: Grover
authors.forename: Pooja
authors.initials: P
authors.lastname: Arora
authors.forename: Vikas
authors.initials: V
authors.lastname: Manchanda
mesh_terms: D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D015725:Fluconazole / Q000009:adverse effects / Q000627:therapeutic use*; D006118:Griseofulvin / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009281:Naphthalenes / Q000009:adverse effects / Q000627:therapeutic use*; D000077291:Terbinafine; D014006:Tinea Capitis / Q000188:drug therapy* / Q000382:microbiology; D014249:Trichophyton
chemical_list: D000935:Antifungal Agents; D009281:Naphthalenes; D006118:Griseofulvin; D015725:Fluconazole; D000077291:Terbinafine