Terbinafine pulse therapy is effective in tinea capitis

Terbinafine pulse therapy was found to be effective and safe in the treatment of tinea capitis in an open study of 13 children (age range 3-13 years, mean 6.4 years, 7 males, 6 females, Tricohphyton tonsurans 7 patients, T. violaceum 6 patients). Each pulse of active therapy lasted 1 week with a 2 weeks off period between the first two pulses and a 3 weeks off period between the second and third pulses of treatment. The dosage of terbinafine was determined by the weight of the child: >40 kg, 250 mg/day, 20 to 40 kg, 125 mg/day and <20 kg, 62.5 mg/day. Twelve (92.3%) of 13 children achieved complete clinical and mycological cure when evaluated 12 weeks after starting therapy with the number of pulses for complete (clinical and mycological) cure being one pulse (two patients with mild severity of tinea capitis), two pulses (four patients with mild disease) and three pulses (mild disease: two patients, moderate disease: two patients, and severe disease: three patients). One child with moderate severity disease failed to clear after three pulses of terbinafine. There were no adverse effects observed in any of the 13 patients during the course of therapy. All the parents found it easy to administer therapy and the compliance was high.