Systemic antifungal therapy for tinea capitis in children: An abridged Cochrane Review

S1 guidelines: Tinea capitis

“…than of ectothrix infections (for example, M. canis). Chen et al [69,70] concluded in their updated Cochrane review (25 randomized controlled trials with 4,449 participants) that, while griseofulvin and terbinafine were both effective, the former was especially effective for treating infections caused by Microsporum/Nannizzia spp. In a recent review, Gupta et al [68] summarized the results of 21 randomized and 17 non-randomized controlled trials.…”

“…As these agents primarily target the cell membrane by inhibiting ergosterol biosynthesis, they are fully effective only against proliferating fungi, yet not against fungal spores or resting mycelia, which do not synthesize new ergosterol [86]. (meta-analyses in [68][69][70]) are attributable to the fact that one causes ectothrix involvement; the other, endothrix infections. It has been demonstrated that terbinafine levels in adult sebum may be as high as 45.1 µg/mL.…”

“…Intake with a fatty meal increases absorption and thus bioavailability. Approximately 20 % of patients experience adverse effects, primarily gastrointestinal symptoms (diarrhea in particular) as well as drug eruptions and headache [68][69][70]. and 8-12 weeks or more for Microsporum spp., or until fungal cultures are negative.…”

“…The drug is well tolerated and shows no differences in safety profile in children compared to adults [1][2][3][68][69][70]. In 0.8 % of patients, treatment has to be discontinued [68][69][70]. In 0.8 % of patients, treatment has to be discontinued [68][69][70].…”

“…Doses of 50-100 mg/day for four weeks and 5 mg/kg/day for 2-4 weeks have been shown to be similarly effective as griseofulvin and terbinafine [68][69][70]77]. The drug inhibits ergosterol synthesis in the cell wall.…”