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Itraconazole pulse therapy is effective in the treatment of tinea capitis in children: an open multicentre study
A K Gupta1, M E Alexis, N Raboobee
1Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada.
Insights
Itraconazole pulse therapy effectively treated tinea capitis in children. This antifungal treatment showed high cure rates and was well-tolerated, indicating promising results for pediatric fungal infections.
Area of Science:
- Dermatology
- Mycology
- Pediatric Infectious Diseases
Background:
- Tinea capitis is a common superficial fungal infection affecting children.
- Effective and safe treatment options for tinea capitis are crucial for pediatric populations.
- Itraconazole is a broad-spectrum antifungal agent with potential for treating dermatophytoses.
Purpose of the Study:
- To evaluate the efficacy and safety of itraconazole pulse therapy for treating tinea capitis in children.
- To determine the optimal number of itraconazole pulses for achieving clinical and mycological cure.
- To assess patient compliance and tolerability of the itraconazole pulse regimen.
Main Methods:
- An open-label, multicenter study involving 10 pediatric patients with tinea capitis.
- Treatment administered as itraconazole pulse therapy: 5 mg/kg/day for 1 week, followed by 2 weeks off.
- Causative agents identified included Trichophyton tonsurans, T. violaceum, T. soudanense, and Microsporum gypseum.
Main Results:
- Complete clinical and mycological cure was achieved in 10 out of 10 patients after one, two, or three pulses.
- Six patients achieved cure after two pulses, and three patients required three pulses.
- The treatment was well-tolerated with no reported clinical or laboratory adverse effects.
- High compliance was observed with the 1-week pulse therapy regimen.
Conclusions:
- Itraconazole pulse therapy is an effective and safe treatment for tinea capitis in children.
- A 1-week pulse regimen demonstrated high cure rates and excellent tolerability.
- Further evaluation in larger patient cohorts is warranted to confirm these promising preliminary findings.
Abstract:
In an open multicentre study we have demonstrated that itraconazole pulse therapy, 5 mg/kg per day, is effective and safe in the management of tinea capitis in 10 children (seven boys, three girls, mean age: 6.6 years, age range 4-11 years). The causative organisms were Trichophyton tonsurans (six cases), T. violaceum (two cases), T. soudanense (one case) and Microsporum gypseum (one case). Each pulse of drug therapy lasted 1 week with 2 weeks off between consecutive pulses. One, two and three pulses produced complete, clinical and mycological, cure in one, six and three patients, respectively. The children tolerated the treatment well and there were no clinical or laboratory adverse effects. This 1-week pulse therapy regimen resulted in a high degree of compliance. The preliminary results of this study are promising and need to be evaluated in a larger sample of patients.