Terbinafine in the Treatment of <i>Trichophyton</i> Tinea Capitis: A Randomized, Double-Blind, Parallel-Group, Duration-Finding Study

Friedlander, Sheila Fallon; Aly, Raza; Krafchik, Bernice R.; Blumer, Jeffrey L.; Honig, Paul J.; Stewart, Daniel; Lucky, Anne W.; Gupta, Aditya K.; Babel, Dennis E.; Abrams, Beatrice B.; Gourmala, Nouciba; Wraith, LindaAnn; Paul, Carle

doi:10.1542/peds.109.4.602

Cited by 74 publications

(48 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…44,[152][153][154][155] Corresponding mycological cure rates observed after 1, 2, 4 and 6 weeks of treatment were 60%, 76%, 72% and Ͼ90%, respectively. 44,152,154 By contrast, infections with Microsporum are less responsive to terbinafi ne. Response rates as low as 15% are observed with 1 to 2 weeks of therapy.…”

Section: Tinea Capitismentioning

confidence: 91%

“…152,153 Effi cacy rates ranged from 69% to 86% after 2 weeks of treatment, averaged 65% with 4 weeks of treatment and ranged from 80% to 100% after 6 weeks of therapy. 44,[152][153][154][155] Corresponding mycological cure rates observed after 1, 2, 4 and 6 weeks of treatment were 60%, 76%, 72% and Ͼ90%, respectively. 44,152,154 By contrast, infections with Microsporum are less responsive to terbinafi ne.…”

Section: Tinea Capitismentioning

confidence: 99%

“…165,[182][183][184] Most terbinafine related adverse events are mild or moderate and include gastrointestinal complaints (eg, nausea, abdominal pain, vomiting, diarrhea), cutaneous eruptions, weight gain, appetite changes, headaches, and vertigo. 43,152,165,185,186 Those adverse reactions involving the gastrointestinal system and skin are most commonly associated with discontinuation of therapy, 165,186 with the risk of discontinuation estimated at 3.4%. 187 Serious adverse drug reactions, most commonly involving the liver and the hematologic system, are only rarely reported with terbinafi ne use (0.04%).…”

Section: Adverse Effectsmentioning

confidence: 99%

See 2 more Smart Citations

Update on terbinafine with a focus on dermatophytoses

Newland¹,

Abdel‐Rahman

2009

CCID

View full text Add to dashboard Cite

Since terbinafi ne was introduced on the world market 17 years ago, it has become the leading antifungal for the treatment of superfi cial fungal infections, aided by unique pharmacologic and microbiologic profi les. This article reviews mode of action, antimycotic spectrum and disposition profi le of terbinafi ne. It examines the data, accumulated over 15 years, on the comparative effi cacy of terbinafi ne (vs griseofulvin, itraconazole, fl uconazole) in the management of the infections for which it is primarily indicated (eg, dermatophytoses) and provides a brief discussion on its use for the treatment of non-dermatophyte infections. Finally, the available data on the newest topical and systemic formulations are introduced.

show abstract

Section: Tinea Capitismentioning

confidence: 91%

Section: Tinea Capitismentioning

confidence: 99%

Section: Adverse Effectsmentioning

confidence: 99%

See 1 more Smart Citation

Update on terbinafine with a focus on dermatophytoses

Newland¹,

Abdel‐Rahman

2009

CCID

View full text Add to dashboard Cite

show abstract

“…Trichophyton rubrum, among other dermatophytes, is a major causative agent for superficial dermatomycoses like onychomycosis and tinea pedis (19,26) and is known to account for as many as 69.5% of all dermatophyte infections (4,5,18). Common therapeutic strategies based on the use of terbinafine and griseofulvin are generally considered effective (6,7,11). Terbinafine is very widely used, both orally and topically, in the therapy of dermatophyte infections, with no reports of resistance against this allylamine antifungal (16,24).…”

mentioning

confidence: 99%

Clinical Trichophyton rubrum Strain Exhibiting Primary Resistance to Terbinafine

Mukherjee

Leidich

Isham

et al. 2003

Antimicrob Agents Chemother

275

226

View full text Add to dashboard Cite

The in vitro antifungal susceptibilities of six clinical Trichophyton rubrum isolates obtained sequentially from a single onychomycosis patient who failed oral terbinafine therapy (250 mg/day for 24 weeks) were determined by broth microdilution and macrodilution methodologies. Strain relatedness was examined by random amplified polymorphic DNA (RAPD) analyses. Data obtained from both broth micro-and macrodilution assays were in agreement and revealed that the six clinical isolates had greatly reduced susceptibilities to terbinafine. The MICs of terbinafine for these strains were >4 g/ml, whereas they were <0.0002 g/ml for the susceptible reference strains. Consistent with these findings, the minimum fungicidal concentrations (MFCs) of terbinafine for all six strains were >128 g/ml, whereas they were 0.0002 g/ml for the reference strain. The MIC of terbinafine for the baseline strain (cultured at the initial screening visit and before therapy was started) was already 4,000-fold higher than normal, suggesting that this is a case of primary resistance to terbinafine. The results obtained by the broth macrodilution procedure revealed that the terbinafine MICs and MFCs for sequential isolates apparently increased during the course of therapy. RAPD analyses did not reveal any differences between the isolates. The terbinafine-resistant isolates exhibited normal susceptibilities to clinically available antimycotics including itraconazole, fluconazole, and griseofulvin. However, these isolates were fully cross resistant to several other known squalene epoxidase inhibitors, including naftifine, butenafine, tolnaftate, and tolciclate, suggesting a target-specific mechanism of resistance. This is the first confirmed report of terbinafine resistance in dermatophytes.

show abstract

“…The lack of efficacy of the initial treatment might have resulted from an incorrect medication or insufficient treatment duration [10]. Retrospectively, this last hypothesis seems to be more likely, as terbinafin, used in the first phase of treatment, has been reported to be highly effective [11]. Most antifungals exert only fungistatic activity, therefore they only temporarily inhibit fungal growth.…”

Section: Discussionmentioning

confidence: 99%

Trichophyton mentagrophytes-associated Majocchi’s granuloma treated with cryotherapy

Pietrzak¹,

Tomasiewicz²,

Kanitakis³

et al. 2012

Folia Histochem Cytobiol.

View full text Add to dashboard Cite

Abstract:We here report the case of a woman with dermatophytosis of the thighs due to Trichophyton mentagrophytes where an unusual clinical picture posed considerable diagnostic and therapeutic problems. She presented numerous skin lesions located on the dorsolateral face of the left thigh and the medial surface of the right calf. The initial lesions consisted of small itchy pustules that evolved to exfoliation after scratching. Results of histopathologic examination of a skin biopsy were consistent with dermatophytosis, although the negativity of PAS staining did not allow confirmation of this diagnosis. Direct microscopic examination with 10% KOH was negative; however, skin cultures on BioMerieux media revealed Tr. Mentagrophytes. Following the diagnosis of Trichophyton infection, the patient was treated with a combination of isoconazole nitrate and difluocortolone valerate. After therapy, both direct microscopic mycologic examination and culture on BioMerieux medium were negative; however, the lesions persisted, assuming a completely different aspect. Cryotherapy with liquid nitrogen was started. This led to a spectacular improvement: the surface of the skin became almost normal, merely showing slight discoloration. An unusual clinical presentation and non-responsiveness to treatment should prompt revision of the primary diagnosis. A negative result of direct microscopy should not exclude the diagnosis of dermatophytosis. Cryotherapy should be considered in cases that do not respond to conventional antifungal medication.

show abstract

Terbinafine in the Treatment of Trichophyton Tinea Capitis: A Randomized, Double-Blind, Parallel-Group, Duration-Finding Study

Abstract: When efficacy, cost, and compliance are taken into consideration, 2 weeks of terbinafine therapy appears to be the optimal treatment duration for patients with Trichophyton tonsurans tinea capitis.

Cited by 74 publications

References 19 publications

Update on terbinafine with a focus on dermatophytoses

Update on terbinafine with a focus on dermatophytoses

Clinical Trichophyton rubrum Strain Exhibiting Primary Resistance to Terbinafine

Trichophyton mentagrophytes-associated Majocchi’s granuloma treated with cryotherapy

Contact Info

Product

Resources

About