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Systemic antifungals to treat onychomycosis in children: a systematic review

Aditya K Gupta1, Maryse Paquet

  • 1Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada; Clinical Research, Mediprobe Research Inc, London, Ontario, Canada. agupta@execulink.com

Pediatric Dermatology
|January 3, 2013
PubMed

Insights

Systemic antifungal treatments for childhood onychomycosis (fungal nail infection) demonstrate favorable safety and efficacy. Cure rates in children treated with antifungals are comparable to those observed in adult patients.

Area of Science:

  • Dermatology
  • Pediatric Medicine
  • Pharmacology

Background:

  • Onychomycosis (fungal nail infection) is uncommon in children, leading to limited data on systemic antifungal treatments.
  • Understanding the efficacy and safety of these treatments in pediatric populations is crucial.

Purpose of the Study:

  • To evaluate the efficacy and safety of systemic antifungal therapies for onychomycosis in children.
  • To synthesize available evidence on treatment outcomes in pediatric patients.

Main Methods:

  • A comprehensive literature search was conducted in PubMed and Embase databases, including references of related publications, up to March 2012.
  • Included studies were clinical trials (CTs), retrospective analyses (RAs), and case reports (CRs) involving children (<18 years) treated for onychomycosis.
  • Data from 26 studies published between 1976 and 2011 were analyzed.

Main Results:

  • Systemic antifungals, primarily terbinafine and itraconazole, were most frequently reported for pediatric onychomycosis.
  • Systemic antifungal therapy alone achieved a complete cure rate of 70.8% in children aged 1-17 years.
  • Combined systemic and topical therapy showed an 80.0% complete cure rate in a small group of older children and one infant.

Conclusions:

  • Systemic antifungal therapies for onychomycosis in children appear safe and effective.
  • Treatment outcomes in children are comparable to those reported in adult populations.
  • Further research is warranted due to the limited data available.

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