A comparative study of efficacy and safety of oral griseofulvin versus oral terbinafine in patients with tinea capitis at a tertiary care hospital

Abstract

Background: Tinea capitis is a common dermatophytic infection of the scalp hair follicle and the intervening skin with an incidence in rural India of about 28.5%. Antifungal agent terbinafine which requires a shorter course of treatment than conventional griseofulvin is being compared. Aims and Objectives: The objective of the current study was to compare the efficacy and safety of oral griseofulvin and oral terbinafine in tinea capitis among children aged 3–14 years. Materials and Methods: An open-label, prospective, comparative study was conducted with clearance and approval from the Institutional Ethics Committee, and assent was taken from all participants. Children between the ages of 3 and 14 years were enrolled for over 24 months. Patients with clinically diagnosed and laboratory-confirmed tinea capitis were randomized into two groups of 50 each. Group A was given oral griseofulvin for 8 weeks and Group B was given oral terbinafine for 4 weeks. Results: Early response was obtained in Group B treated with terbinafine, and a statistically significant reduction in clinical symptoms was obtained at 4 weeks compared to griseofulvin with P = 0.044. Mycological cure was achieved at the end of 6 weeks in the terbinafine group, with P = 0.034 compared to the griseofulvin group in which 3 patients remained KOH positive at 8 weeks. Conclusion: Both drugs were well tolerated with no serious adverse effects. Terbinafine is an effective alternative to griseofulvin in pediatric patients with tinea capitis with a shorter duration of treatment and fewer adverse effects.