A randomized double-blind comparative study of terbinafine for 1, 2 and 4 weeks in tinea capitis

Abstract

We report a randomized, double-blind study, comparing the relative efficacy and tolerability of oral terbinafine, given for 1, 2 or 4 weeks, in tinea capitis. Of 161 evaluable patients, 53 were treated with terbinafine for 1 week, 51 for 2 weeks and 57 for 4 weeks. Isolated pathogens included Trichophyton violaceum (71.5%), T. tonsurans (14.9%), T. verrucosum (4.3%), Microsporum audouinii (4.3%), M. canis (2.5%), T. schoenleinii (1.9%) and T. mentagrophytes (0.6%). The final evaluation, at 12 weeks, showed cure rates of 73.6, 80.4 and 85.9%, in the respective groups. The adverse effects noted, were not drug related. In our opinion, terbinafine given for 1, 2 or 4 weeks, is equally effective for most cases of tinea capitis.

Terbinafine hydrochloride oral granules versus oral griseofulvin suspension in children with tinea capitis: Results of two randomized, investigator-blinded, multicenter, international, controlled trials∗

“…The findings in the current study extend previous results showing efficacy of conventional terbinafine tablets in the treatment of tinea capitis. 20,[22][23][24][25][26][27] These findings are consistent with evidence from several other studies showing that terbinafine treatment is at least as effective as griseofulvin. 24,25,[28][29][30] In those studies, outcomes were generally dependent on underlying pathogen and dose and duration of treatment.…”

“…In published studies, data indicate that mycologic cure can range from 61% to 86% after 2 to 4 weeks of treatment with terbinafine. [20][21][22]24 Similarly, mycologic cure rates with griseofulvin therapy have been reported to range from 62% to 96% with 8 to 12 weeks of therapy. 24,25,[35][36][37] The relatively low cure rates seen in our study may be attributed to several reasons, including and beyond disease characteristic and drug dose.…”

“…1 While itraconazole and fluconazole are fungistatic agents like griseofulvin, 10,16 in vitro studies have demonstrated fungicidal activity of terbinafine against dermatophytes belonging to the Trichophyton and Microsporum genera, [17][18][19] and a variety of clinical investigations have shown efficacy of terbinafine in children with tinea capitis. [20][21][22][23][24][25][26][27][28][29][30] In a number of comparative studies, 2-to 4-week terbinafine treatment has been shown to be at least as effective as 6-to 8-week griseofulvin treatment. 24,[28][29][30][31] CaceresRios et al 29 demonstrated a superior complete cure rate with 4-week terbinafine treatment versus 8-week griseofulvin treatment in patients with Trichophyton-dominant tinea capitis, but the dose range of griseofulvin (6.25 to 12.5 mg/kg per day) in this study was low.…”

Antifungal agents for common outpatient paediatric infections

“…It is effective for children with tinea capitis at a dose of 62.5 mg/day to 250 mg/day for four weeks (44)(45)(46)(47)(48). Topical terbinafine 1% formulations have been effective when applied once or twice daily for two weeks.…”

Pharmacotherapy of Tinea Capitis

“…Increased hepatic enzyme levels (40 percent) and eosinophilia (25 percent) were the most common adverse effects, followed by elevated triglyceride levels (20 percent), leukocytosis (10 percent), and headache (5 percent). 21 The major pharmacokinetic drug interactions with the antifungal medications in the treatment of tinea capitis either involve factors affecting gastrointestinal absorption or drug metabolism. The azoles (ketoconazole, itraconazole, and fluconazole) inhibit cytochrome P-450 3A4 and 2C9, and thus impair the metabolism of drugs, leading to toxic concentrations of concurrendy administered drugs in some patients.…”