Oral terbinafine in tinea capitis in children

Tinea capitis is a disease that frequently affects children. In most cases systemic antimycotic treatment is necessary. Griseofulvin is still the drug of choice, but requires prolonged periods of treatment (several months). To estimate the efficiency and tolerability of terbinafine for treatment of tinea capitis in children, four patients (aged 3-9 years) with tinea capitis proven by culture were treated with terbinafine at a dose of 125 mg a day for different periods (4-10 weeks). Isolates were subjected to minimal inhibitory concentration testing against terbinafine and griseofulvin. In all four cases terbinafine treatment resulted in complete remission. The clinical response was accompanied by negative culture results on follow-up. Terbinafine was well tolerated in each case. Determination of the minimal inhibitory concentration confirmed the excellent in vitro activity of terbinafine against dermatophytes. Controlled studies involving a larger number of children are necessary to answer questions concerning dose and duration of terbinafine treatment as well as the frequency and severity of drug-related side-effects.