Griseofulvin and Fluconazole Reduce Transmission of Tinea Capitis in Schoolchildren

Abstract

No statistically significant differences were found between treatment groups. Griseofulvin and fluconazole reduced the potential for disease transmission in children with TC, with griseofulvin being more effective for M. canis infections, although children with TC may be potentially contagious even after up to 3 weeks of treatment. These data should be considered regarding school attendance of children with TC.

Emergence of African species of dermatophytes in tinea capitis: A 17‐year experience in a Montreal pediatric hospital

“…In our experience, terbinafine is not as effective as griseofulvin for clinical and mycologic eradication of M. audouinii . This is consistent with other studies reporting higher cure rates with griseofulvin than with newer antifungals for Microsporum species . For terbinafine, we suggest that dosing should be 6‐8 mg/kg/d up to 250 mg/d for Microsporum species infections.…”

“…In recent decades, an increase in TC due to African species of dermatophytes has been reported from cosmopolitan centers in Europe and the Middle East (Table ) . In the Montreal area over the past 17 years, although the overall number of TC cases did not change significantly (mean 344 per year), there was a sixfold increase in African species of dermatophyte infections in children mainly due to anthropophilic M. audouinii and T. soudanense (from 6/82 [7%] in 2000 to 37/95 [39%] in 2016).…”

“…Prescriptions for antifungal drugs such as terbinafine, itraconazole, and fluconazole have increased because of their shorter and simpler treatment regimens and accessibility . In a group of Israeli children, griseofulvin and fluconazole were shown to reduce potential disease transmission and eradicate TC, although griseofulvin was more effective than fluconazole against M. canis infections . At our center, TC cases were treated for at least 6 weeks with terbinafine 62.5 mg/d for children weighing less than 20 kg, 125 mg/d for those weighing 20‐40 kg, and 250 mg/d for those weighing 40 kg.…”

A case report of tinea capitis in infant in first year of life

“…Nevertheless griseofulvin is the cheapest agent in tablet form, has the last potential drug interactions, and is available as a suspension. Among all the alternative drugs to griseofulvin for the treatment of TC, the most promising, as reported by Shemer et al [12], is fluconazole; in fact, the azole was found in children to have efficacy similar to that griseofulvin in infection due to M. canis, T. verrucosum and T. violaceum . This drug also reaches high concentrations in the epidermis and persists for several weeks, and is optimal for children because it is supplied as a rectal preparation or syrup and can be used only once weekly [12].…”

“…Binder et al reported that TC caused by Microsporum species may be treated with a longer duration of itraconazole and 5 mg/kg/day is used for infantile superficial fungal infections within 3 to 6 weeks [13]. However, griseofulvin remains the drug of choice in infants, because it is efficacious (it can penetrate the hair sheath well), it has lower cost and excellent safety profile and continues to be the better treatment option for TC due to M. canis [3, 4, 6, 12].…”