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Systemic antifungal treatment of children with terbinafine
1Department of Dermatology and Allergy, Biederstein, Technical University, Munich, Germany.
Insights
Terbinafine effectively treated fungal infections in children. While generally well-tolerated, further studies are needed to optimize dosage and treatment duration for specific infections like tinea capitis.
Area of Science:
- Dermatology
- Pediatric Mycology
Background:
- Griseofulvin is the sole licensed oral antifungal for pediatric dermatophytosis.
- Limited therapeutic options necessitate evaluation of alternative treatments.
Purpose of the Study:
- To assess the efficacy and tolerability of oral terbinafine in children.
- To evaluate terbinafine as a treatment for tinea capitis and tinea corporis.
Main Methods:
- Systemic terbinafine treatment was administered to 15 children (14 months–11 years) with confirmed fungal infections.
- Infections included tinea capitis, tinea corporis, and combined infections caused by Trichophyton violaceum, Microsporum canis, and Trichophyton mentagrophytes.
Main Results:
- All children achieved mycological and clinical cure after 4–8 weeks of terbinafine therapy.
- Relapse occurred in two cases of tinea capitis due to M. canis within 1–2 months post-treatment.
- Terbinafine demonstrated good overall tolerability, with one instance of acute urticaria.
Conclusions:
- Oral terbinafine is effective for pediatric dermatophytosis.
- Extended treatment duration or higher doses may be required for M. canis scalp infections.
- Further prospective studies are essential to establish optimal pediatric dosing and treatment regimens.
Background:
At present, griseofulvin is the only licensed drug for oral treatment of dermatophyte infections in children.
Objective:
Children were treated with the fungicidal allylamine terbinafine. Efficacy and tolerability were evaluated.
Methods:
Fifteen children (14 months to 11 years old, below 40 kg body weight) with culture-confirmed tinea capitis or tinea corporis were systemically treated with terbinafine. Five children suffered from tinea capitis, 6 from tinea corporis and 4 from a combined infection of the scalp and body. As causing agents Trichophyton violaceum (5), Microsporum canis (8) and Trichophyton mentagrophytes (2) were isolated.
Results:
Mycological and clinical cure was achieved in all children after oral treatment with terbinafine for 4-8 weeks. Cure after discontinuation of therapy could be observed in 13 children. Two children with tinea capitis caused by M. canis relapsed within 1-2 months after the end of therapy. The overall tolerability of terbinafine in children was good; 1 child suffered from acute urticaria during treatment, which might be related to the medication.
Conclusions:
The applied therapy regimes were effective in most cases. In scalp infections by M. canis, the children should be treated for more than 4 weeks or with a higher dose. To find the optimal dosage and treatment periods for children, further prospective studies are necessary.