Terbinafine Offers Advantages in Tinea Capitis - Brief Article

0 Comments | Family Practice News, April 1, 2001 | by Jennifer M. Wang

MIAMI BEACH -- Early experience suggests that terbinafine may eventually replace griseofulvin as the prescription of choice for the treatment of patients with tinea capitis, Dr. Ronald C. Hansen said at the annual Masters of Pediatrics conference sponsored by the University of Miami.

The current dosing guidelines for terbinafine therapy seem to be effective in spite of "wildly varying" allowances, said Dr. Hansen, who is a pediatric dermatologist at the University of Arizona in Tucson.

The rules of thumb for treating children specify the use of a quarter tablet per day for patients who weigh under 20 kg, half a tablet per day for those who weigh 20-40 kg, and one tablet per day for those who weigh more than 40 kg. There is no pediatric formulation for the drug, so the 250-mg tablets must be split by hand, he noted.

The 2- to 3-week time frame for terbinafine therapy translates into better patient compliance, compared with the 6 to 12-week regimen for griseofulvin. The new drug seems to be more effective than griseofulvin for Trichophyton tonsurans, which is the most common cause of tinea capitis in the United States, and terbinafine is free of griseofulvin's problem of resistance, Dr. Hansen said.

Terbinafine is poor therapy for fluorescent tinea stemming from M. canis, he added.

Other options for treating tinea capitis include itraconazole and fluconazole. However, they are not well studied for this indication and are not approved by the Food and Drug Administration. Further, itraconazole does not come in a pediatric dosage form.

Despite the efficacy of terbinafine, griseofulvin should-remain the first-line treatment for tinea capitis, because it is currently the only product that is FDA-approved for pediatric use, Dr. Hansen recommended.