Comparison of Terbinafine and Griseofulvin for Tinea Capitis

Abstract

Dermatology| May 01 2001 Comparison of Terbinafine and Griseofulvin for Tinea Capitis AAP Grand Rounds (2001) 5 (5): 49–50. https://doi.org/10.1542/gr.5-5-49 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Comparison of Terbinafine and Griseofulvin for Tinea Capitis. AAP Grand Rounds May 2001; 5 (5): 49–50. https://doi.org/10.1542/gr.5-5-49 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: griseofulvin, terbinafine, tinea capitis Source: Fuller LC, Smith CH, Cerio R, et al. A randomized comparison of 4 weeks of terbinafine vs. 8 weeks of griseofulvin for the treatment of tinea capitis. Br J Dermatol. 2001;144:321–327. To compare the efficacy of griseofulvin and terbinafine for the treatment of tinea capitis, the authors enrolled 210 subjects from 6 centers in the United Kingdom aged 2–16 years (mean age 6 years) with mycologically proven tinea capitis and randomly assigned them to receive either daily oral griseofulvin (10 mg/kg) for 8 weeks or oral terbinafine (<20 kg, 62.5 mg; 20–40 kg, 125 mg; >40 kg, 250 mg) for 4 weeks. Subjects in both groups also used selenium sulfide shampoo at least twice weekly for 2 weeks. Compliance, adverse effects and clinical response were assessed and mycological testing performed at baseline and weeks 4, 8, 12, and 24. One hundred and forty-seven subjects completed the study (70 in the griseofulvin group and 77 in the terbinafine group). There were no significant differences between groups with respect to presence of a kerion, causative agent, age, gender, or race. Eighty-six percent of infections were caused by Trichophyton species (82% of these were due to T tonsurans) and 24% by Microsporum species (86% of these were due to M audouinii). Overall, there were no differences in cure rates between treatment groups. However, the results suggested that the causative organism and subject’s weight influenced outcome. Among those infected with Trichophyton species, 77% in the terbinafine group and 62% in the griseofulvin group had achieved a mycological cure at week 8 (P=.07). In contrast, in subjects infected with Microsporum species, 18% of those who received terbinafine and 50% who received griseofulvin were mycologically cured at week 8 (P=.18). Of subjects infected with Trichophyton species who weighed more than 20 kg, 36% in the terbinafine group and 13% in the griseofulvin group were cured at week 4 (P=.03). No serious adverse events were observed. The authors conclude that 4 weeks of treatment with oral terbinafine has similar efficacy to 8 weeks of oral griseofulvin. The study by Fuller et al is one of several recent reports documenting the efficacy of terbinafine for the treatment of tinea capitis.1–,4 Their results indicate that 4 weeks of terbinafine and 8 weeks of griseofulvin possess comparable efficacy. The study has several limitations, including a limited assessment of compliance (eg, pill counts were not performed). High and progressive subject attrition may have compromised the ability to detect a difference between treatments, altered apparent cure rates, and limited the assessment of relapse rates. The dose of griseofulvin employed (10 mg/kg/d), while appropriate in the UK, would be considered inadequate in the US where most experts advise 20 mg/kg/d.5 These findings also support the observation that terbinafine may be most useful in the treatment of infections caused by Trichophyton species, but less so when Microsporum species are responsible.6 This is of particular interest... You do not currently have access to this content.