From the cochrane librarySystemic antifungal therapy for tinea capitis in children: An abridged Cochrane Review
Section snippets
Methods
Our analysis is based on a Cochrane Review most recently updated in the Cochrane Library 2016, issue 5 (www.thecochranelibrary.com).4 Full details of the methods and all the included studies are available from the Cochrane Review.
Results
We included a total of 25 RCTs7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31 with 4449 participants (Fig 1). All were parallel group studies, and 10 had a multiarm design. Sample size varied from 13 to 1549 participants. Each of the 25 studies reported the types of fungus cultured. Trichophyton species predominated over Microsporum species in the included studies; T tonsurans and M canis caused infection in the highest proportion of participants.
Discussion
Current evidence supports that both griseofulvin and terbinafine are an effective first-line choice for children with tinea capitis infected with Trichophyton or Microsporum species; however, terbinafine may be a better choice for those infected with T tonsurans, whereas griseofulvin may be a better choice for those infected with M canis. We did not find any evidence to support a difference in terms of adherence between 4 weeks of terbinafine versus 8 weeks of griseofulvin.
Limited evidence
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Cited by (55)
Antimicrobials and resistance part II: Antifungals, antivirals, and antiparasitics
2022, Journal of the American Academy of DermatologyCitation Excerpt :Griseofulvin is approved for tinea capitis, extensive tinea pedis, cruris, corporis, and dermatophyte onychomycosis; however, terbinafine offers higher clinical and mycologic cure rates.6,8,21,22 Due to greater efficacy against ectothrix infections of the hair shaft compared to terbinafine, griseofulvin remains a preferred agent for Microsporum-associated tinea capitis.6,23 Griseofulvin has been associated with erythema multiforme, Stevens-Johnson syndrome, urticaria, angioedema, fixed drug eruption, drug-induced porphyria, and cutaneous lupus.
New Epidemiological Outcomes in Anthropophilic tinea capitis, a Case Series Study in Northwestern Spain
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This article has no funding sources. However, the original version of the Cochrane Review was funded by the Cochrane Skin Group; Cochrane Child Health Field; Alberta Research Center for Child Health Evidence; University of Alberta, Canada; Spanish Society of Dermato-Epidemiology and Evidence-based Dermatology; and the Clínica Plató, Fundació Privada of Barcelona.
Disclosure: Professor Bennett is the proprietor of Systematic Research Ltd and derives an income from her work as a freelance researcher. She was paid for her contributions to this review by the Cochrane Skin Group. In addition, she holds an honorary chair at Coventry University, but this does not constitute a competing interest. Drs Chen, Jiang, Yang, González, Lin, Hua, Xue, and Zhang have no conflicts of interest to declare.
This article is an abridged version of a Cochrane Systematic Review that was published in the Cochrane Library 2016, issue 5, doi: 10.1002/14651858.CD004685.pub3. (see www.thecochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and Cochrane Database of Systematic Reviews should be consulted for the most recent version of the review.