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Treatment for Tinea Capitis: Griseofulvin or Terbinafine?
A meta-analysis suggests that 4-week courses of terbinafine work as well as 8-week courses of griseofulvin in children with ringworm.
Children who have tinea capitis usually are treated with oral griseofulvin for 6 to 8 weeks. Investigators in Philadelphia conducted a meta-analysis to determine whether short courses of terbinafine yield an equivalent outcome. They reviewed six studies involving 603 children with culture-proven tinea capitis. Children were assigned randomly to either griseofulvin (
6 weeks) or terbinafine (2 weeks).
In an analysis that included all data, no difference was found in the rate of cure at 12 weeks after treatment started. However, one study involved only children in which an uncommon organism, microsporum, was the causative agent. When the remaining five studies (469 children) were analyzed, the cure rate at 12 weeks favored terbinafine, although the difference was not quite significant. The cure rate at 8 weeks (data from four studies) showed virtually no difference.
Comment: Adhering to a 6- to 8-week course of griseofulvin for tinea capitis is quite difficult. Although terbinafine, like many other drugs we use in pediatrics, is not FDA-approved for children, it is growing in popularity. A 4-week course of terbinafine appears to be at least as good as a longer course of griseofulvin.
— Howard Bauchner, MD
Published in Journal Watch General Medicine November 16, 2004
Citation(s):
Fleece D et al. Griseofulvin versus terbinafine in the treatment of tinea capitis: A meta-analysis of randomized, clinical trials. Pediatrics 2004 Nov; 114:1312-5.
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- why is terbinafine not work well against Microsporum spp
egypt e, 18 Oct 2010 11:38 AM EST
Specialty: Forensic Psychiatry
why is terbinafine not work well against Microsporum spp
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