A randomized comparison of 4 weeks of terbinafine vs. 8 weeks of griseofulvin for the treatment of tinea capitis
Article first published online: 20 AUG 2003
British Journal of Dermatology
Volume 144, Issue 2, pages 321–327, February 2001
How to Cite
Fuller, L.C., Smith, C.H., Cerio, R., Marsden, R.A., Midgley, G., Beard, A.L., Higgins, E.M. and Hay, R.J. (2001), A randomized comparison of 4 weeks of terbinafine vs. 8 weeks of griseofulvin for the treatment of tinea capitis. British Journal of Dermatology, 144: 321–327. doi: 10.1046/j.1365-2133.2001.04022.x
- Issue published online: 20 AUG 2003
- Article first published online: 20 AUG 2003
- Accepted for publication 21 September 2000
- tinea capitis
Background Tinea capitis is a common childhood infection that has recently become more frequent in urban areas in Europe and the U.S.A. The current licensed treatment in children is griseofulvin 10 mg kg−1 daily, which is usually given for 6–8 weeks.
Objectives To compare this treatment with a 4-week course of oral terbinafine.
Methods Terbinafine was given at the following doses: in children weighing < 20 kg, 62·5 mg daily; 20–40 kg, 125 mg daily; > 40 kg, 250 mg daily. Two hundred and ten children aged 2–16 years, with mycologically confirmed tinea capitis, were randomized to 4 weeks treatment with terbinafine or 8 weeks with griseofulvin, and followed for a total of 24 weeks to determine the difference between treatments with respect to short- and long-term efficacy and tolerability.
Results One hundred and forty-seven patients were evaluable (terbinafine 77, griseofulvin 70). Although the 4-week course of terbinafine resulted in a trend to more rapid clearance of tinea capitis, there were no statistically significant differences between the two drugs in terms of overall outcome or tolerability, apart from in a subgroup of patients with Trichophyton infections, and weighing > 20 kg, who responded better to terbinafine than to griseofulvin at 4 weeks. By contrast, there was a better response to griseofulvin than to terbinafine in patients with Microsporum audouinii infections.
Conclusions Overall, the study showed that 4 weeks of treatment with oral terbinafine has similar efficacy to 8 weeks of treatment with griseofulvin for the management of tinea capitis in children.