Published online November 1, 2004
PEDIATRICS Vol. 114 No. 5 November 2004, pp. 1312-1315 (doi:10.1542/peds.2004-0428)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Web of Science (9)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fleece, D.
Right arrow Articles by Aronoff, S. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fleece, D.
Right arrow Articles by Aronoff, S. C.
Related Collections
Right arrow Infectious Disease & Immunity
Right arrowRelated AAP Red Book topics:
Tinea Capitis (Ringworm of the...
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

REVIEW ARTICLE

Griseofulvin Versus Terbinafine in the Treatment of Tinea Capitis: A Meta-analysis of Randomized, Clinical Trials

David Fleece, MD*, John P. Gaughan, PhD{ddagger} and Stephen C. Aronoff, MD*

* Departments of Pediatrics
{ddagger} Physiology, Temple University School of Medicine, Philadelphia, Pennsylvania

Objective. Tinea capitis, a common pediatric infection in the United States, is caused mainly by Trichophyton species and affects many urban children. Although the current treatment of choice is oral griseofulvin, terbinafine has been shown to be variably effective in several comparative, randomized trials. The purpose of this study was to perform a meta-analysis of randomized, clinical trials comparing the efficacies of oral terbinafine and oral griseofulvin for the treatment of childhood tinea capitis.

Methods.The Medline database was searched for randomized, clinical studies comparing griseofulvin and terbinafine for the treatment of tinea capitis. Acceptance criteria included oral administration of griseofulvin for at least 6 weeks and the identification of a pathogenic dermatophyte from the scalp at the time of enrollment in the study. Scalp culture status at least 8 weeks after enrollment was used as the outcome. The common odds ratio (OR) with 95% confidence intervals (CIs), the Cochran-Mantel-Haenszel test for significance, and the Breslow-Day test for homogeneity were calculated.

Results.Six articles that satisfied all inclusion criteria were identified. These studies were combined by using outcomes at 12 to 16 weeks after enrollment. The common OR was 0.86 (95% CI: 0.57–1.27). When the 5 studies that identified Trichophyton species as the predominant pathogen were combined, using outcomes 12 weeks after enrollment, the results nearly favored terbinafine (OR: 0.65 [95% CI: 0.42–1.01]). For outcomes at 8 weeks after enrollment, no difference was found between the agents (OR: 0.84 [95% CI: 0.54–1.32]).

Consclusions.A 2- to 4-week course of terbinafine is at least as effective as a 6- to 8-week course of griseofulvin for the treatment of Trichophyton infections of the scalp. Griseofulvin is likely to be superior to terbinafine for the rare cases caused by Microsporum species.

Key Words: tinea capitis • Trichophyton • Microsporum • terbinafine • griseofulvin • meta-analysis

Abbreviations: OR, odds ratio • CI, confidence interval

Accepted May 10, 2004.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 AAP Grand RoundsHome page
K. A. Horii
Terbinafine vs Griseofulvin for Tinea Capitis
AAP Grand Rounds, November 1, 2008; 20(5): 49 - 50.
[Full Text] [PDF]

Home page
 DTBHome page
Managing scalp ringworm in children.
DTB, December 1, 2007; 45(12): 89 - 92.
[Abstract] [Full Text] [PDF]

Home page
 Antimicrob. Agents Chemother.Home page
D. M. Saunte, F. Simmel, N. Frimodt-Moller, L. B. Stolle, E. L. Svejgaard, M. Haedersdal, C. Kloft, and M. C. Arendrup
In Vivo Efficacy and Pharmacokinetics of Voriconazole in an Animal Model of Dermatophytosis
Antimicrob. Agents Chemother., September 1, 2007; 51(9): 3317 - 3321.
[Abstract] [Full Text] [PDF]

Home page
 JWatch PediatricsHome page
Treatment for Tinea Capitis: Griseofulvin or Terbinafine?
Journal Watch Pediatrics and Adolescent Medicine, November 29, 2004; 2004(1129): 3 - 3.
[Full Text]

Home page
 JWatch GeneralHome page
Treatment for Tinea Capitis: Griseofulvin or Terbinafine?
Journal Watch (General), November 16, 2004; 2004(1116): 1 - 1.
[Full Text]