Griseofulvin vs terbinafine for paediatric tinea capitis: When and for how long

J, Bar; Samuelov, Liat; Sprecher, Eli; Mashiah, Jacob

doi:10.1111/myc.12970

Cited by 15 publications

(11 citation statements)

References 22 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The pyrimidine analogue 5-fluorocytosine inhibits DNA and RNA synthesis, leading to defects in cell division and protein synthesis (Dietz et al 2019). Griseofulvin interferes with microtubule formation, impairing fungal growth and cell division (Bar et al 2019). Finally, ciclopirox oleamine functions as a protein synthesis inhibitor, which is often used against dermatophytes (Sonthalia et al 2019).…”

Section: Limited Cellular Targets and Side Effects Of Available Antifmentioning

confidence: 99%

Major challenges and perspectives in the diagnostics and treatment of dermatophyte infections

2020

View full text Add to dashboard Cite

Dermatophytes are the aetiological factors of a majority of superficial fungal infections. What distinguishes them from other pathogenic filamentous fungi is their unique ability to degrade keratin. The remarkable ability of this group of fungi to survive in different ecosystems results from their morphological and ecological diversity as well as high adaptability to changing environmental conditions. Paradoxically, despite the progress in medicine, the prevalence of dermatophyte infections is increasing from year to year. At the beginning of the third millennium, practical diagnostic and therapeutic options are still very limited. This review focuses on understanding the major problems in this aspect of dermatophyte infections and indicates future strategies and perspectives for novel approaches to identification and drugs for elimination of dermatophytes. Particular importance is placed on development of a strategy for a diagnostic pathway and implementation of rapid and reliable diagnostics methods designed by international teams. Furthermore, among compounds that currently arouse great interest, representatives of terpenoids, alkaloids, saponins, flavonoids and essential oils deserve attention. Many of these compounds are undergoing clinical trials as potential antifungal agents, and future research should focus on attempts at determination of the applicability of tested substances. Finally, the advantages and disadvantages in implementation of new diagnostic paths and medicinal substances for routine use are indicated. Journal of Applied Microbiology

show abstract

Section: Limited Cellular Targets and Side Effects Of Available Antifmentioning

confidence: 99%

Major challenges and perspectives in the diagnostics and treatment of dermatophyte infections

2020

View full text Add to dashboard Cite

show abstract

“…For a refugee patient, considered a part of a high-risk population, a full physical examination should be performed. If ndings like scaling, alopecia or pruritis are identi ed, the physician must rely on his clinical index of suspicion and should treat in accordance with the highest degree of suspicion, by providing empirical treatment, from the rst encounter [19], as culture results may only be provided after 2-4 weeks and advanced test, such as PCR, may not be available in most outpatient clinics. Prescriptions for the entire treatment period should be given in advance, because it might be the only encounter with the patient.…”

Section: Resultsmentioning

confidence: 99%

“…Due to the relative resistance to traditional dosages of griseofulvin observed in this population and failure to regularly follow up, these patients should be treated at a higher dosage than usual. Although treatment decisions rely on the identity of the fungus [14,[19][20], griseofulvin at a dosage of up to 50 mg/kg/day is recommended for rst-line treatment, since it provides a su cient clinical response. In addition, years of experience with the drug have demonstrated its long-term safety 13 ; it has the fewest known drug interactions [15], a favorable adverseeffect pro le 21 and rarely induces serious adverse-reactions [2].…”

Section: Resultsmentioning

confidence: 99%

Tinea Capitis in an Immigrant Pediatric Community; A Clinical Signs-Based Treatment Approach

Kassem

Shmase

Nitzan

et al. 2021

Preprint

View full text Add to dashboard Cite

Tinea capitis is a common cutaneous infection of the scalp and hair follicles, typically diagnosed by direct examination and culture. Treatment with oral antifungals is usually withheld until mycology results are available. In Israel, African refugee children demonstrate higher susceptibility to Tinea capitis and generally fail to undergo follow-up evaluations. This study aimed to identify the clinical characteristics and treatment response of refugee children in Israel with Tinea capitis, in order to formulate a treatment plan, for primary care physicians. To this end, demographic, clinical and laboratory data were extracted from the electronic medical records of 76 refugee children presenting with Tinea capitis during 2016-2017. Scaling was the most common clinical finding. Cultures were positive in 64 (84%) and direct examination in 65 (85%) cases, with a positive correlation between the tests in 75% of cases. The most common fungal strain was T. violaceum. Fluconazole treatment failed in 27% of cases. Griseofulvin 50 mg/kg/day was administered to 74 (97%) of the children, and induced clinical responses. No side effects were reported. In African refugee children with suspected Tinea capitis, a culture, direct examination and empiric treatment with griseofulvin 50 mg/kg/day are recommended to prevent outbreak of an epidemic.

show abstract

“…Our cohort was subdivided into three treatment groups based on changes in treatment guidelines by the Israeli Ministry of Health 13 . All patients underwent baseline laboratory tests 2 weeks prior to treatment initiation.…”

Section: Resultsmentioning

confidence: 99%

“…In recent years, the necessity of laboratory monitoring was questioned given the low rate of adverse effects leading some authors to advice against routine laboratory tests monitoring in patients treated with these drugs 9‐11 . The aim of this study was to evaluate the rate and severity of abnormal laboratory test results in a population of paediatric refugees from Eastern Africa who live in Israel and were treated with oral Terbinafine or Griseofulvin for TC 12,13 …”

Section: Introductionmentioning

confidence: 99%

Laboratory monitoring during antifungal treatment of paediatric tinea capitis

Aleohin

Bar‐Ilan

et al. 2020

Mycoses

Self Cite

View full text Add to dashboard Cite

Griseofulvin and terbinafine are considered effective first‐line therapies for tinea capitis (TC). Haematological dyscrasias and hepatic injury are possible adverse effects with both drugs. There is a debate in the literature regarding the necessity of laboratory monitoring during griseofulvin and terbinafine treatment. We aimed at assessing the prevalence and severity of haematological and hepatic laboratory test abnormalities in a paediatric cohort of African immigrants in Tel‐Aviv with TC who were treated with Terbinafine or Griseofulvin. We conducted a retrospective study of all TC cases diagnosed and treated at the paediatric dermatology clinic, Tel‐Aviv Medical centre, between June 2013 and March 2019. Epidemiologic, clinical and laboratory data were collected. Our cohort included 321 patients of whom 225 (70%) were treated with Griseofulvin and 96 (30%) with Terbinafine. We identified a total of 64 (20%) patients with haematological or hepatic laboratory test abnormalities that in most cases (96.3%) were considered as mild. No difference in laboratory abnormalities prevalence was identified between the griseofulvin and terbinafine groups (21.3% and 16.6%, respectively). Only one patient treated with Griseofulvin revealed significantly increased levels of hepatic aminotransferases that required discontinuation of treatment. Mild elevation in hepatic transaminases is relatively common among paediatric patients treated with systemic antifungal treatment for TC. However, significant laboratory abnormalities are extremely rare and may be diagnosed and addressed early through periodic laboratory tests monitoring.

show abstract

Griseofulvin vs terbinafine for paediatric tinea capitis: When and for how long

Cited by 15 publications

References 22 publications

Major challenges and perspectives in the diagnostics and treatment of dermatophyte infections

Major challenges and perspectives in the diagnostics and treatment of dermatophyte infections

Tinea Capitis in an Immigrant Pediatric Community; A Clinical Signs-Based Treatment Approach

Laboratory monitoring during antifungal treatment of paediatric tinea capitis

Contact Info

Product

Resources

About