Fluconazole for the treatment of tinea capitis in children

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

“…Furthermore, some earlier trials were conducted in populations living in underdeveloped tropical countries with a different spectrum of causative organisms, 15,17 and these species apparently had more favorable response rates to fluconazole. More permissive definitions of ''cure'' in earlier studies [14][15][16][17] were also contributing factors to the favorable clinical cure rates reported previously. Finally, our trial may not have been of sufficient duration to detect a subset of mycological cures that would have eventually occurred had the study had been extended to 12 or 16 weeks, as in previous studies.…”

“…Relatively low sample sizes in earlier trials, ranging from only 20 to 61 patients per study, [14][15][16][17] may have resulted in overestimation of the efficacy of fluconazole. Furthermore, some earlier trials were conducted in populations living in underdeveloped tropical countries with a different spectrum of causative organisms, 15,17 and these species apparently had more favorable response rates to fluconazole.…”

“…First, priority was given to test other hypotheses. On the basis of the apparent success of fluconazole in previous studies, [14][15][16][17] it was hypothesized that a 3-week course of fluconazole might also be comparable or superior in efficacy to a 6-week course of griseofulvin at the labeled dose. A third arm (fluconazole 6 mg/kg/day for 3 weeks followed by placebo for 3 weeks) was employed to test this hypothesis.…”

“…On the basis of its apparent success in previous studies, [14][15][16][17] it was hypothesized that fluconazole might have a therapeutic effect that was superior to that of griseofulvin. We used a randomized, multicenter, third-party-blind superiority study to test this hypothesis; to verify the safety, efficacy, and optimal duration of fluconazole therapy in children with tinea capitis; and to compare the efficacy of fluconazole to that of standard-dose griseofulvin.…”

Antifungal agents for common outpatient paediatric infections

“…The drug is hydrophilic and, thus, present mainly in bodily fluids rather than in keratin or lipids (30). It is, therefore, not useful for routine treatment of most superficial fungal infections (31,32).…”