Griseofulvin Group Research Articles

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

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.

Photodynamic therapy of tinea capitis in children using curcumin loaded in nanospanlastics: A randomized controlled comparative clinical study

Tinea capitis is a common scalp dermatophyte infection in children. Treatment necessitates oral antifungal therapy which represents a therapeutic challenge. Photodynamic therapy (PDT) has emerged as a new antifungal therapeutic approach. The efficacy of PDT depends on the proper choice of the photosensitizer and its delivery system. Curcumin, a natural polyphenol, is well studied as a photosensitizer, however, its hydrophobicity hinders its clinical use. This study aims to improve the use of curcumin in PDT by loading it to a novel vesicular nano spanlastics (NVS) and examine their efficacy in PDT of tinea capitis.A prospective, randomized, controlled comparative study was conducted. Fifty-two children with Tinea Capitis were randomly divided into four groups; Cur-PDT group, oral griseofulvin group, topical curcumin group, and blue light group. Clinical and dermoscopic assessments were done, at baseline, every two weeks and after 6 months for follow-up. The results were confirmed by potassium hydroxide (KOH) 10% and fungal culture before and after the treatment. Complete cure was based on clinical, dermoscopic, and mycological cures.Cur-PDT group showed complete clearance in 46% of children with variable response among fungal species, compared to 100% in the griseofulvin group. No effects were observed in curcumin or light groups. Cur-PDT group showed very mild tolerable burning pain. Griseofulvin group experienced systemic side effects in some cases. Cur-PDT can be a promising well-tolerated alternative treatment of tinea capitis, but with variable responses among fungal species.

Comparison of itraconazole and griseofulvin for treatment of tinea corporis in Bac Ninh Dermatology Hospital

Objective: To compare the efficacy of oral itraconazole with griseofulvin for tinea corporis treatment at Bac Ninh Dermatologic Hospital. Subject and method: A randomized, comparative and prospective study was conducted to compare 66 patients with tinea corporis at Bac Ninh Dermatologic Hospital. These patients were divided into 2 groups: Group 1: Consisted of 31 patients treated with oral Itraconazole (Kbat), and Group 2: Had 35 patients treated with oral Griseofulvin. Result: The result of tinea corporis treatment both clinically and microscopically was the same in two groups. The adverse effects were most seen in the group treated with oral Itraconazole, and the cost for treatment in the Itraconazole group was 7 times higher than in the Griseofulvin group. Conclusion: Oral griseofulvin for tinea corporis was effective and not too pricey.

Comparative study of oral terbinafine vs. oral griseofulvin in the management of tinea capitis

<p class="abstract"><strong>Background:</strong> Tinea capitis (TC) is a common dermatophyte infection affecting primarily prepubertal children. The present study has been designed to assess the clinico-etiological profile of the T capitis and to compare the efficacy and tolerability of terbinafine with griseofulvin.</p><p class="abstract"><strong>Methods:</strong> One hundred fifty eight patients of T. capitis were divided into two groups of 79 patients each to receive either oral griseofulvin or terbinafine (according to weight). Patients in both the groups were followed up at 2, 4, 12 and 36 weeks. At every visit, clinical improvement was evaluated using clinical assessment severity score and the compliance, tolerability and side effects of the drugs were assessed along with KOH microscopy, fungal culture from the lesion and relevant blood investigations.<strong></strong></p><p class="abstract"><strong>Results:</strong> The clinical assessment score were statistically similar in group G and group T at the start of therapy. The decline in scores in both treatment groups was statistically significant at each follow up visit. In griseofulvin group, the mean score was declined from 5.9 at baseline to 4.24 at week 2 and 2.79 at week 4, 0.82 at week 12 and 1.24 at 36 week. In the terbinafine group, the score had a mean of 6.23 at 0 week and 4.03 at week 2, 2.32 at week 4, 0.69 at week 12 and 0.83 at week 36.</p><p><strong>Conclusions:</strong> At follow up study long lasting tissue effect of terbinafine was found but effect of griseofulvin was waned at 36 week. So terbinafine may be better option with similar side effect profile but it is better in residual clinical and mycological effect at higher cost.</p>

Oral antifungal medication for toenail onychomycosis.

Oral antifungal medication for toenail onychomycosis.

Comparative study of Griseofulvin versus Terbinafine in treatment of Tinea Corporis patients

Background: Dermatophytosis is a superficial infection of keratinized tissue. It is the most common type of cutaneous fungal infection seen in human beings affecting skin, hair and nails. Tinea corporis is one of the most common clinical forms of dermatophytosis. Objective: To compare two oral antifungal drugs, Griseofulvin and Terbinafine in the treatment of Tinea corporis Methods: This is an open-label, randomized, parallel, comparative study which was carried out in 100. Patients with tinea corporis infection who attended the outpatient Department of Dermatology, Dr. PSIMS & RF, Chinaoutpalli, Krishna (Dist), between October 2009 and Aug 2011. This study was approved by the institutional Ethical Committee of Dr. PSIMS & RF. Written consent was taken from all the patients enrolled in the study. Results: tinea corporis in the present study was more common between 18-45 yrs of age group and it is more common in females. In the Griseofulvin group, I patient showed no clinical improvement, 13 showed partial improvement and 32 patients (69.57%) were completely cured. In the Terbinafine group, 5 patients showed partial improvement and 43 patients (89.58%) were completely cured by the end of 4th week. Conclusion: Terbinafine 250 mg tablet taken once daily for 2 weeks is more effective in complete cure (both clinical and mycological cure) and showed an early clinical response in treatment of tinea corporis compared to Griseofulvin 250 mg tablet taken twice daily for 4 weeks. There was no significant difference between the two drugs regarding tolerability.

A randomized controlled trial assessing the efficacy of fluconazole in the treatment of pediatric tinea capitis

Griseofulvin is considered first-line therapy for tinea capitis, and the Physician's Desk Reference currently recommends 11 mg/kg per day microsize formulation for use in children. Diverse selective pressures have resulted in waning clinical efficacy of griseofulvin, such that higher doses and longer courses of treatment are required. These events have prompted the search for therapeutic alternatives. Fluconazole is one such treatment option, and a variety of studies using this drug have shown promise in the treatment of pediatric tinea capitis. We sought to assess the efficacy, safety, and optimal dose and duration of fluconazole therapy compared with standard-dose griseofulvin (11 mg/kg per day microsize formulation) in the treatment of pediatric tinea capitis. This randomized, multicenter, third-party-blind, 3-arm trial was designed as a superiority study to identify a therapeutically superior agent/regimen from the 3 treatment arms: (1) fluconazole 6 mg/kg per day for 3 weeks followed by 3 weeks of placebo, (2) fluconazole 6 mg/kg per day for 6 weeks, and (3) griseofulvin 11 mg/kg per day for 6 weeks. Efficacy variables included mycological, clinical, and combined outcomes. The primary efficacy variable was the combined outcome of the modified intent-to-treat population at week 6. Patient safety was assessed throughout the study. Statistical analysis of the efficacy variables was conducted by means of the Cochran-Mantel-Haenszel test. At the end of treatment, mycological cures were present in 44.5%, 49.6%, and 52.2% of the fluconazole 3-week, fluconazole 6-week, and griseofulvin groups, respectively. Analysis of the primary efficacy variable failed to identify any superior agent, and differences between the combined outcomes of the fluconazole 6-week and griseofulvin groups at week 6 were not significant (P = .32). Regarding mycological, clinical, and combined outcomes, no significant differences between the fluconazole 6-week and griseofulvin groups were detected at any time point in the study. No new safety concerns were raised by this trial, and the incidence of treatment-related adverse events noted in this study is concordant with previous reports. Patients in the fluconazole arms of the study fared similarly. At the end of the trial, the difference in mycological cures between the fluconazole arms was only 7.5%, and increases in the incidence of certain treatment-related adverse events were observed in the fluconazole 6-week group. Adjunctive topical therapies and the impact of infected contacts were not assessed in this trial. Systemic therapy with fluconazole 6 mg/kg per day and standard-dose griseofulvin produces comparable but low mycological and clinical cure rates. The limited efficacy of standard-dose griseofulvin and the lack of consensus regarding dose and duration of griseofulvin therapy in tinea capitis emphasize the need for controlled trials to identify optimal treatment parameters. Although the efficacy of fluconazole is no better than that of standard-dose griseofulvin, it may still be useful in select patients with a contraindication or intolerance to high-dose griseofulvin. The outcomes observed in this trial highlight the need to more clearly define the relative importance of adjunctive topical therapies and the evaluation and treatment of infected contacts as factors affecting cure rates.

Influence of Griseofulvin treatment on semen quality in the dog

Griseofulvin is used to treat dermatomycosis in many species and causes oligospermia in supra-pharmacological doses. The aim of the present study was to evaluate the effect of Griseofulvin administered at therapeutic doses upon semen quality in dogs. Four dogs were treated with Griseofulvin (25 mg/kg per day) for 30 days. Semen collections and analyses were performed before, during and for 100 days after treatment for the Griseofulvin group and 10 untreated control dogs. Semen analyses included mean percentage of forward progressively motile sperm, total sperm output, normal live sperm and normal dead sperm. There was no significant difference between control and treated dogs for each of the semen quality parameters. Therapeutic dosage of Griseofulvin had no deleterious effect upon semen quality in dogs, although this does not preclude potential embryotoxic and teratogenic effects.

Comparison of Terbinafine and Griseofulvin for Tinea Capitis

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.

Comparative study of the efficacy and tolerability of 4 weeks of terbinafine therapy with 8 weeks of griseofulvin therapy in children with tinea capitis

Background: Ringworm of the scalp is a dermatophyte infection prevalent in pre-school and school-aged children. Tinea capitis is one of the few superficial fungal infections that does not adequately respond to topical treatment and requires 6-8 weeks of oral antifungal therapy. The aim of this double-blind study was to compare the efficacy and tolerability of terbinafine therapy with griseofulvin therapy in children with mycologically proven tinea capitis. METHODS: In a randomized, double-blind study, efficacy and tolerability of terbinafine given orally once daily for 4 weeks were compared with those of griseofulvin given orally once daily for 8 weeks. A total of 78 subjects were enrolled (39 in the terbinafine group, and 39 in the griseofulvin group). Among these, 7 subjects in the terbinafine group and 4 subjects in the griseofulvin group dropped out. The study included 67 subjects (32 in the terbinafine group and 35 in the griseofulvin group) and the mean age was 7.0 years (range 2-13 years) in the terbinafine group and 6.6 years (range 2-12 years) in the griseofulvin group. Clinical and mycological examination of hair samples were performed at the initial clinical assessment and after the 2nd, 4th, 6th, 8th and 12th weeks. Biochemical and haematological parameters were measured at the initial clinical assessment and after weeks 4, 8 and 12. RESULTS: At the final follow-up visit (week 12), a mycological cure was recorded in 88.0% of the terbinafine-treated group, compared with 91.0% of the griseofulvin-treated group. Effective treatment (complete disappearance of signs and symptoms and negative mycology, or not more than two signs or symptoms of mild erythema, desquamation or pruritus) was recorded in 78% of subjects in the terbinafine-treated group compared with 74% of subjects in the griseofulvin-treated group. Trichophyton species and Microsporum canis showed similar responsiveness to terbinafine treatment, CONCLUSION: Terbinafine given for 4 weeks was well tolerated and was as effective as griseofulvin used for 8 weeks in the treatment of tinea capitis in children.

A multicentre (double-blind) comparative study to assess the safety and efficacy of fluconazole and griseofulvin in the treatment of tinea corporis and tinea cruris

In a double-blind, parallel group study we compared fluconazole 150 mg once weekly with griseofulvin 500 mg once daily for 4-6 weeks in the treatment of tinea corporis or tinea cruris. Eighty-four of 114 patients (74%) (39% after 3 weeks) were clinically cured in the fluconazole group compared with 72 of 116 (62%) (39% after 3 weeks) in the griseofulvin group (P = 0.06). In the fluconazole group 78% were mycological cured compared with 80% in the griseofulvin group. In the fluconazole group nine patients (7.5%) had treatment related adverse events and in the griseofulvin group 15 patients (12.5%) had adverse events. Fluconazole 150 mg once weekly for 6 weeks is both clinically and mycologically effective in the treatment of tinea corporis and tinea cruris and few side-effects were reported.

Comparative multicentre double-blind study of terbinafine (250 mg per day) versus griseofulvin (1 g per day) in the treatment of dermatophyte onychomycosis

A multicentre randomized double-blind study of 143 patients was conducted to compare terbinafine (250 mg/day) and micronized griseofulvin (1 g/day) in the treatment of dermatophyte onychomycosis. The duration of treatment was up to 12 months, but the treatment could be interrupted in the event of complete cure, i.e. clinical disappearance of the pathological zone of the nail combined with mycological cure. The percentage of nails cured was significantly higher in the terbinafine than in the griseofulvin group (77.1% versus 45.7%, P=0.0001). Clinical and biological tolerability were good in both groups. Only 7.4% of patients treated with terbinafine showed one or more adverse events, but 31.5% with griseofulvin (P<0.001).

Treatment of Toenail Onychomycosis

Background and Design: The fungicidal mode of action of terbinafine should make it feasible to reduce treatment duration in onychomycosis. For this reason, a randomized, double-blind study in 195 patients with severe dermatophyte infections of the toenails was performed comparing a 24-week treatment with terbinafine (250 mg/d) with a 48-week treatment with micronized griseofulvin (1000 mg/d). Results: After 48 weeks, effective treatment was achieved in 67% of the patients treated with terbinafine and in 56% of those treated with griseofulvin (two-tailed P =.120). At a follow-up visit 24 weeks later, cure rates had de- creased to 60% in the terbinafine group and to 39% in the griseofulvin group (two-tailed P =.006). At the same time, the mycological cure rate was 81% with terbinafine and 62% with griseofulvin (two-tailed P =.02). Conclusions: This study has demonstrated the longterm therapeutic superiority of terbinafine to high-dose griseofulvin in the treatment of toenail mycosis. Furthermore, with the new antifungal terbinafine, treatment is no longer necessary until all affected nail material has grown out. (Arch Dermatol. 1995;131:919-922)

Double-blind, parallel-group comparison of terbinafine and griseofulvin in the treatment of toenail onychomycosis

Background: Griseofulvin has been used in the treatment of toenail onychomycosis with limited success. Evidence suggests that terbinafine may be more effective. Objective: In a double-blind, parallel-group study we compared 250 mg/day terbinafine for 16 weeks with 500 mg/day griseofulvin for 52 weeks (or for shorter periods in cured patients) in patients with toenail onychomycosis. Methods: Eighty-nine patients with culture-proved tinea unguium were included, and 43 in the terbinafine group and 41 in the griseofulvin group were assessable for efficacy. Patients who had not improved after 16 weeks were entered into an open study and were given 250 mg/day terbinafine for 16 weeks with the study code still blinded and were then followed up for 20 weeks. Results: Terbinafine was significantly more effective than griseofulvin, with 42% being completely cured and 84% mycologically cured compared with only 2% with total cure and 45% with mycologic cure in the griseofulvin-treated group. The number of side effects was significantly lower in the terbinafine group (11%) compared with the griseofulvin group (29%). Conclusion: Terbinafine is significantly more effective than griseofulvin in the treatment of toenail onychomycosis.

Italian multicentre trial comparing itraconazole with griseofulvin in the treatment of dermatomycoses. Preliminary results

AbstractThe results of previous international studies have suggested that itraconazole is significantly superior to griseofulvin in the treatment of tinea corporis/cruris. The aim of our study was to compare the efficacy and tolerability of the two agents in a larger number of patients with dermatomycoses. This study is ongoing in 46 Italian Centers of Dermatology. From this total of 46 Centers, the patients of 16 Centers have been included for the “ad interim” analysis. One hundred and thirty‐four patients were randomized to treatment with either itraconazole 100 mg once daily for 15 days (73 patients) or griseofulvin 375–1000 mg daily for a mean of 17 days (61 patients). The patients were assessed clinically and mycologically before entering the trial, at the end of therapy and again 30 days after the end of treatment. Both groups showed a statistically significant improvement in desquamation, erythema and subjective complaints, with a trend in favour of itraconazole, despite the significantly shorter duration of treatment. Thirty days after the end of therapy, microscopic results were negative in 91.5% of the itraconazole group and 71.7% of the griseofulvin group. Cultures were negative in 80% and 65%, respectively. A significantly higher proportion of patients in the itraconazole group than in the griseofulvin group experienced both clinical and mycological recovery. One patient in the itraconazole group and three in the griseofulvin group reported adverse experiences. The preliminary results of this study show that itraconazole is well tolerated and more effective than griseofulvin. Furthermore, itraconazole demonstrated a more rapid action than griseofulvin.

Effect of ursodeoxycholic acid on experimental hepatic porphyria induced by griseofulvin

Griseofulvin(GF) has become the drug of choice as an antifungal agent for patients who suffer from many kinds of fungal infection. In order to clarify hepatic injury by griseofulvin(GF) overload and the effect of UDCA on GF-induced hepatic injury, the authors carried out biochemical, histologic, and ultrastructural studies of liver following treatment with griseofulvin and ursodeoxycholic acid(UDCA) in mice. Urine porphobilinogen excretion in the group treated with GF alone was significantly increased and reached the highest level in the 4th week and declined thereafter. Biochemical studies of the liver function showed no remarkable changes of serum bilirubin levels throughout the experimental period in all groups, except for SGPT and alkaline phosphatase activities which were significantly elevated and reached the highest level in the second week. Then they slightly decreased in GF treated groups(GF alone and GF plus UDCA) in comparison with the control group. Pathologic findings in the group treated with GF alone include focal liver cell necrosis(esp, zone 3), Mallory bodies in hepatocytes(esp, zone 1), Kupffer cell activation, and brown protoporphyrin pigments in the hepatocytes, bile canaliculi and interlobular bile ducts with a marked inflammatory cell infiltration in the portal tracts. Under the polarizing light microscope, bile ductular and canalicular thrombi showed a "Maltese cross" birefringence in mice treated with GF alone. There is no definite finding of fatty change in hepatocyte. Under the microscope, the liver appeared normal with an intact lobular architecture in the GF plus UDCA treated group. Electron microscopically, GF-induced changes include swelling of mitochondria, globular protoporphyrin crystals in the hepatocyte cytoplasm, markedly dilated bile cannaliculi and bile ducts and the formation of a Mallory hyaline bodies in the hepatocytes. There were no noticeable structural changes in the GF plus UDCA-treated group. Therefore the results suggest that GF causes hepatic injury, namely porphyria and cholestasis, and the treatment of UDCA may have cytoprotective and choleretic effects on GF-induced hepatic injuries.

A comparative double-blind study of terbinafine (Lamisil) and griseofulvin in tinea corporis and tinea cruris

In a double-blind randomized study, 92 patients with culturally proven tinea corporis and/or tinea cruris were treated orally with either terbinafine (Lamisil) (125 mg b.i.d.) or griseofulvin (500 mg b.i.d.) for up to 6 weeks. The two groups of patients and distribution of the target lesions were similar, but the analysis of the clinical scores showed that the terbinafine group had slightly higher mean scores at baseline (P = 0.186). At the end of therapy the proportion of patients with negative microscopy and culture was 78% in the terbinafine group and 83% in the griseofulvin-treated group. At the assessment 8 weeks after the end of therapy the percentages of terbinafine- and griseofulvin-treated patients with negative mycology were 93 and 95%, respectively. There were three relapses after mycological cure in the griseofulvin group (8%) and two in the terbinafine group (4%). Griseofulvin-treated patients were treated for shorter periods than terbinafine-treated patients (i.e. 58% compared to 26% received only 2-4 weeks of therapy). In terms of overall effectiveness, there were no significant differences between the two treatments. Thirty-seven terbinafine patients (77%) compared to 36 griseofulvin patients (82%) had overall effective therapy. Eight terbinafine patients (16%) compared to 10 griseofulvin patients (20%) experienced at least one adverse event. Five patients in the terbinafine group and six in the griseofulvin group had to stop the treatment due to headaches or gastrointestinal disorders. One terbinafine patient had an elevation of liver function tests after 6 weeks of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

A Comparison of a New Oral Antifungal, Terbinafine, With Griseofulvin as Therapy for Tinea Corporis

Fifty patients with tinea corporis were treated with either 500 mg of griseofulvin (microsize) or 500 mg of terbinfine daily for 6 weeks. Thirty-three patients completed the study. Thirteen (87%) of 15 patients who took terbinafine were considered successfully treated, while 13 (73%) of 18 patients in the griseofulvin group noted resolution of their disease. Five patients taking griseofulvin were forced to discontinue the therapy because of side effects, compared with two patients taking terbinafine. This preliminary study indicates that a new oral antifungal agent of the allylamine class, terbinafine, may possess a safety and efficacy profile similar to that of griseofulvin.

Double blind study of ketoconazole and griseofulvin in dermatophytoses

Ketoconazole and griseofulvin were compared in a double blind fashion in 47 children with dermatophytosis and positive fungal culture. After 6 weeks of therapy there was clinical and mycologic cure or improvement of the lesions in 92% of patients treated with ketoconazole (Group A) and in 76% of those given griseofulvin (Group B). A patient in Group A showed clinical deterioration of the lesions after 4 weeks of treatment, although modification of antifungal therapy was not necessary to achieve final healing. One ketoconazole-treated patient relapsed within 7 days after cessation of therapy. In Group B the antifungal agent was changed in five cases due to worsening or slow resolution of the lesions and persistence of positive cultures after 6 weeks of treatment. Both ketoconazole and griseofulvin were useful drugs for treatment of dermatophytoses in children.

Oral ketoconazole as an alternative to griseofulvin in recalcitrant dermatophyte infections and onychomycosis

In an open study 58 patients with chronic dermatophytosis mainly caused by Trichophyton rubrum and five patients with Tinea capitis were treated with ketoconazole. The indications were ineffectiveness of or side effects to griseofulvin. Response to treatment varied from 1 week in scalp infections to 11 weeks in toe-nail lesions. Dermatophytosis of hands and feet were cured in 25%, marked improvement observed in further 30%. Toe- and finger-nail infections were cured in 20% and 43%, respectively, and marked improvement seen in further 36% and 14%, respectively. All scalp infections were cured without relapse. Recurrence of infections before 6 months after treatment was seen in 55-60% of hand and foot lesions and 33-38% of finger and toe-nail infections. In a double-blind study 20 patients with onychomycosis caused by T. rubrum the efficacy of ketoconazole was compared to that of griseofulvin. Cure rates in the griseofulvin group were 25% for finger-nails and zero for toe-nails, while 50% and 57% experienced marked improvement. In the ketoconazole group, 25% of finger-nail infections were cured and 75% markedly improved, while the corresponding figures for toe-nails were 11% and 89%, respectively. Adverse reactions to ketoconazole were seen in 29 (46%) of the patients in the open study and in 2 (20%) in the double-blind study and comprised mainly minor complaints. Side effects caused discontinuation in 12 patients, in two of whom due to toxic hepatitis.