A randomized comparison of 4 weeks of terbinafine vs. 8 weeks of griseofulvin for the treatment of tinea capitis

Abstract

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.

Terbinafine hydrochloride oral granules versus oral griseofulvin suspension in children with tinea capitis: Results of two randomized, investigator-blinded, multicenter, international, controlled trials∗

“…Overall, data showed similar safety and tolerability of terbinafine oral granules and griseofulvin suspension in this pediatric population and confirmed previous findings of comparable safety and tolerability of the two agents. 25,34 The safety results reported herein confirm the overall good safety and tolerability profile of terbinafine similar to previously reported findings. 21,31 In conclusion, the present findings add to accumulating evidence of the safety and effectiveness of terbinafine as an antifungal agent and indicate that the new formulation of terbinafine oral granules may also be a safe and effective treatment for tinea capitis in children.…”

“…The findings in the current study extend previous results showing efficacy of conventional terbinafine tablets in the treatment of tinea capitis. 20,[22][23][24][25][26][27] These findings are consistent with evidence from several other studies showing that terbinafine treatment is at least as effective as griseofulvin. 24,25,[28][29][30] In those studies, outcomes were generally dependent on underlying pathogen and dose and duration of treatment.…”

“…[20][21][22]24 Similarly, mycologic cure rates with griseofulvin therapy have been reported to range from 62% to 96% with 8 to 12 weeks of therapy. 24,25,[35][36][37] The relatively low cure rates seen in our study may be attributed to several reasons, including and beyond disease characteristic and drug dose. It may at least have been partially due to the absence of adjunctive therapy with topical antifungal agents or ketoconazole shampoo; these are used in the routine management of tinea capitis.…”

“…1 While itraconazole and fluconazole are fungistatic agents like griseofulvin, 10,16 in vitro studies have demonstrated fungicidal activity of terbinafine against dermatophytes belonging to the Trichophyton and Microsporum genera, [17][18][19] and a variety of clinical investigations have shown efficacy of terbinafine in children with tinea capitis. [20][21][22][23][24][25][26][27][28][29][30] In a number of comparative studies, 2-to 4-week terbinafine treatment has been shown to be at least as effective as 6-to 8-week griseofulvin treatment. 24,[28][29][30][31] CaceresRios et al 29 demonstrated a superior complete cure rate with 4-week terbinafine treatment versus 8-week griseofulvin treatment in patients with Trichophyton-dominant tinea capitis, but the dose range of griseofulvin (6.25 to 12.5 mg/kg per day) in this study was low.…”

Update on terbinafine with a focus on dermatophytoses

“…[159][160][161] As above, the exception lies with infections caused by Microsporum where griseofulvin appears to be superior to terbinafi ne even when the allylamine is administered for 12 weeks. [160][161][162] Pulse regimens wherein the standard dose or double the standard dose of terbinafi ne is administered daily for 1 week (followed by 3 weeks off) do not appear to confer any advantage or disadvantage in the treatment of Microsporum infections over standard regimens.…”