Accumulation of Fluconazole in Scalp Hair

Yeates, R A; Laufen, H; Zimmermann, Till; Scharpf, F

doi:10.1002/j.1552-4604.1998.tb04402.x

Cited by 12 publications

(10 citation statements)

References 23 publications

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“…A recent pharmacokinetic study demonstrated that fluconazole penetrates and accumulates in scalp hairs. 8 Two different oral regimens were studied: 50 mg per day for 28 days or a single 150‐mg dose once weekly for 4 weeks. The good clinical response observed in our study is consistent with these pharmacokinetic findings.…”

Section: Discussionmentioning

confidence: 99%

“…Twenty white children (8 girls; 12 boys), ranging in age from 2 to 12 years (most in the age range 5-9 years), were enrolled in a clinical trial with their parents consent to assess the efficacy, safety, and tolerability of a single oral dose of fluconazole given once weekly for [4][5][6][7][8] weeks for the treatment of outpatients with mycologically proven tinea capitis.…”

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confidence: 99%

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Fluconazole in the treatment of tinea capitis

Montero-Gei¹

1998

Int J Dermatology

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Twenty white children (8 girls; 12 boys), ranging in age from 2 to 12 years (most in the age range 5–9 years), were enrolled in a clinical trial with their parents consent to assess the efficacy, safety, and tolerability of a single oral dose of fluconazole given once weekly for 4–8 weeks for the treatment of outpatients with mycologically proven tinea capitis. Ten children had previously undergone an unsuccessful course of treatment with griseofulvin liquid suspension or the ultramicronized formulation and desired alternative therapy. Factors possibly contributing to the lack of success of griseofulvin included living in a tropical area, poor hygiene, insufficient dosages, and malnutrition. Adverse reactions to griseofulvin included skin eruption, nausea, photosensitivity, and drug interactions. Furthermore, the patients became exasperated with the long duration of griseofulvin therapy. The diagnosis of tinea capitis was confirmed on the basis of microscopic examination of arthrospores of the infecting fungus located outside or inside the affected hairs. The primary isolation of the causative pathogens in culture was accomplished using Mycosel (BBL, Baltimore, MD) and Sabouraud dextrose agar. The pathogens recovered were Microsporum canis (13), M. gypseum (5), and Trichophyton tonsurans (2). All cases caused by M. canis were positive under Wood’s light. Patients underwent a physical examination, laboratory tests were performed, and a medical history was obtained from the mother or father of each patient. Any medications taken by the patients at study entry or during the study were recorded. Fluconazole therapy was administered once a week in the presence of the investigator. The dosage was based on body weight. Initially, the fluconazole dose was 6 mg/kg. The dose subsequently was increased to 8 mg/kg based on safety information, including laboratory test results. All patients, except for four, were treated at the higher dose. Shampoos were not used as adjunctive therapy. Patients were assessed weekly for clinical and mycologic response and for the occurrence of adverse events. Adverse event information included the date of onset, duration, severity, and relationship to drug therapy.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Fluconazole in the treatment of tinea capitis

Montero-Gei¹

1998

Int J Dermatology

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“…Fluconazole can be detected in skin for about 2 weeks after stopping therapy [349,350]. Similarly, when uconazole 50 mg day ¼ 1 was administered for 28 days to adults, the drug was detectable in hair for 6 months following completion of therapy [352]. When uconazole 100 mg day ¼ 1 has been administered to adults for 5 days the drug has been detectable in the scalp for 4 -5 months [351].…”

Section: Pharmaco Kineticsmentioning

confidence: 99%

Tinea capitis

2000

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Tinea capitis is a common dermatophyte infection of the scalp in children. Dermatophytes are classified into three genera; tinea capitis is caused predominantly by Trichophyton or Microsporum species. On the basis of host preference and natural habitat, dermatophytes are also classified as anthropophilic, geophilic and zoophilic. The etiological agents of tinea capitis usually fall in the first and last categories. In North America, tinea capitis is now predominantly due to Trichophyton tonsurans. During the past 100 years the most common North American organism for tinea capitis was initially Microsporum canis followed later by M. audouinii. In other parts of the world the epidemiology varies. Tinea capitis is generally observed in children over the age of 6 years and before puberty, with African Americans being the most affected group. Clinical presentations are seborrheic-like scale, 'black dot' pattern, inflammatory tinea capitis with kerion and tiny pustules in the scalp. The clinical diagnosis should be confirmed by mycological examination. Wood's light examination was of value in diagnosing tinea capitis due to M. canis and M. audouinii; however, it is not helpful in T. tonsurans tinea capitis. Asymptomatic carriers may be a significant reservoir of infection and spread of spores may also involve inanimate objects. Carriers may benefit from shampooing their hair. Treatment of tinea capitis requires an oral antifungal agent. The data from the use of terbinafine, itraconazole and fluconazole are promising and suggest that these agents have an efficacy similar to griseofulvin while shortening the duration of therapy. Both griseofulvin and the newer antimycotics have a favorable adverse-effect profile and are associated with high compliance.

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“…The pharmacokinetic data support the use of both continuous and intermittent¯uconazole to treat tinea capitis. 6,7 Other protocols using¯uconazole to treat tinea capitis are once-weekly dosing of 8 mg/kg per day for 6±8 weeks (n 20 patients) 4 and 5 mg/kg per day for 4 weeks. 5 Fluconazole has been reported to be safe in children 6 months±13 years old at doses of 3±12 mg/kg daily 8,9 (¯uconazole package insert, P®zer Roerig, New York, U.S.A., February 1997).…”

Section: Discussionmentioning

confidence: 99%

Intermittent short duration therapy with fluconazole is effective for tinea capitis

Gupta

Adam

Hofstader

et al. 1999

British Journal of Dermatology

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We have demonstrated in an open multicentre investigation that oral fluconazole 6 mg/kg daily for 2 weeks, followed, if clinically indicated four weeks from the start of therapy, by an extra week of treatment at the same dosage, may be effective and safe in the treatment of tinea capitis. Of a total of 48 patients, there were 42 evaluable children < 18 years old (19 boys, 23 girls; mean age 6.2 years, range 1.5-16). The causative organisms were Trichophyton tonsurans (38 subjects) and T. violaceum (four). In the 42 evaluable patients, a 2-week course of fluconazole was administered in 21, with the remainder requiring 1 additional week of therapy. At follow-up 12 weeks from the start of therapy, mycological and clinical cure was recorded in 37 of the 42 evaluable patients (88.1%, 95% confidence interval 83.1-93.1%). The treatment was well tolerated, with no clinical adverse effects. This regimen appears to be effective and safe, and is associated with high compliance. The preliminary results of the investigation need to be evaluated in a larger sample of patients, and in tinea capitis caused by zoophilic species.

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Accumulation of Fluconazole in Scalp Hair

Cited by 12 publications

References 23 publications

Fluconazole in the treatment of tinea capitis

Fluconazole in the treatment of tinea capitis

Tinea capitis

Intermittent short duration therapy with fluconazole is effective for tinea capitis

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