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Published on: February 14, 2018
Systemic antifungal therapy for tinea capitis in children
U González1, T Seaton, G Bergus
1Clinica Plato, Department of Dermatology, c/ Plato 21, Barcelona, Catalunya, Spain, 08006. urba.gonzalez@clinicaplato.com
The Cochrane Database of Systematic Reviews
|October 19, 2007
Summary
Newer antifungal drugs like terbinafine, itraconazole, and fluconazole show similar efficacy to griseofulvin for treating tinea capitis (scalp fungal infection) in children. Shorter treatment durations with these newer options may improve adherence, despite potential higher costs.
Area of Science:
- Dermatology
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Tinea capitis is a prevalent, contagious fungal infection of the scalp in children.
- Systemic antifungal therapy is essential for effective treatment and preventing the spread of tinea capitis.
Purpose of the Study:
- To evaluate the efficacy of systemic antifungal medications for treating tinea capitis in pediatric patients.
- To compare newer antifungal agents with griseofulvin in terms of cure rates and treatment duration.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) involving children under 18 with confirmed tinea capitis.
- Searched multiple databases including Cochrane, MEDLINE, EMBASE, LILACS, CINAHL, ACP journal club, and Healthstar.
- Included trials assessed systemic antifungal therapy in immunocompetent individuals.
Main Results:
- For Trichophyton species, terbinafine (4 weeks) and griseofulvin (8 weeks) demonstrated similar efficacy.
- Itraconazole and fluconazole showed comparable cure rates to griseofulvin, often with shorter treatment durations.
- Limited evidence exists for Microsporum infections, with no significant difference noted between terbinafine and griseofulvin in one small study.
Conclusions:
- Newer systemic antifungals (terbinafine, itraconazole, fluconazole) appear as effective as griseofulvin for Trichophyton-caused tinea capitis in children.
- Shorter treatment regimens with newer agents may enhance patient adherence but could be more costly.
- Further research is needed for Microsporum infections; safety profiles are generally acceptable, though pediatric formulations may be limited.
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