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The use of itraconazole to treat cutaneous fungal infections in children.
Dermatology. 1999; 199(3):248-52.D

Abstract

BACKGROUND

Cutaneous mycoses such as tinea capitis, onychomycosis and some cases of tinea corporis/cruris, and tinea pedis/manus require oral antifungal therapy. There is relatively limited data regarding the use of the newer oral antifungal agents, e.g. itraconazole, in the treatment of these mycoses in children.

OBJECTIVE

We wished to determine the efficacy and safety of itraconazole continuous therapy in the management of cutaneous fungal infections in children.

METHODS

Children with cutaneous mycoses were treated with itraconazole in an open-label manner in 4 studies. For tinea capitis, the treatment regimens using itraconazole continuous therapy were: study 1, 3 mg/kg/day for 4 or 8 weeks; study 2, 5 mg/kg/day for 6 weeks, and study 3, 5 mg/kg/ day for 4 weeks. In a different trial, study 4, itraconazole continuous therapy 5 mg/kg/day was used to treat toenail onychomycosis (duration: 12 weeks), tinea corporis/ cruris (duration: 1 week) and tinea pedis/manus (duration: 2 weeks).

RESULTS

The efficacy rates at follow-up 12 weeks from the start of therapy in children with tinea capitis treated using the itraconazole continuous regimen were: clinical cure (CC) and mycological cure (MC) in study 1 (n = 10, Trichophyton violaceum all patients), CC 50%, MC 86%; in study 2 (n = 35, Microsporum canis 22 patients, Trichophyton sp. 12 patients), CC 82.8%, MC 80%, and in study 3 (n = 16, M. canis 11 patients, Trichophyton sp. 5 patients), (CC 66.7%, MC 78.5%. Itraconazole was also effective in the treatment of dermatomycoses in 24 children (study 4). The CC and MC rates at the follow-up 8 weeks from the start of therapy in children with dermatomycoses and 12 months in children treated for onychomycosis were: onychomycosis (n = 1, T. rubrum), CC 100%, MC 100%; tinea corporis (n = 12, M. canis 10 patients), CC 100%, MC 90%; tinea cruris (n = 3, Trichophyton sp. 2 patients), CC 100%, MC 100%; tinea manus (n = 1, T. rubrum), CC 100%, MC 100%, and tinea pedis (n = 7, T. rubrum), CC 100%, MC 100%). Adverse effects consisted of a cutaneous eruption in 1 (1.2%) of the 85 children, with mild, transient, asymptomatic elevation of liver function tests (less than twice the upper limit of normal) in 2 (3.4%) of 58 children in whom monitoring was performed.

CONCLUSIONS

Itraconazole is effective and safe in the treatment of tinea capitis and other cutaneous fungal infections in children.

Authors+Show Affiliations

Gupta AK
Division of Dermatology, Department of Medicine, Sunnybrook and Women's College Health Sciences Center (Sunnybrook site), and the University of Toronto, Toronto, Canada. agupta@execulink.com
Nolting S
No affiliation info available
de Prost Y
No affiliation info available
Delescluse J
No affiliation info available
Degreef H
No affiliation info available
Theissen U
No affiliation info available
Wallace R
No affiliation info available
Marynissen G
No affiliation info available
De Doncker P
No affiliation info available

MeSH

Antifungal AgentsChildChild, PreschoolDermatomycosesDose-Response Relationship, DrugDrug EruptionsFollow-Up StudiesFoot DermatosesGastritisHeadacheHumansInfantItraconazoleMicrosporumOnychomycosisPatient DropoutsSkinTime FactorsTineaTinea CapitisTinea PedisTreatment OutcomeTrichophyton

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10592406

Citation

Gupta, A K., et al. "The Use of Itraconazole to Treat Cutaneous Fungal Infections in Children." Dermatology (Basel, Switzerland), vol. 199, no. 3, 1999, pp. 248-52.
Gupta AK, Nolting S, de Prost Y, et al. The use of itraconazole to treat cutaneous fungal infections in children. Dermatology. 1999;199(3):248-52.
Gupta, A. K., Nolting, S., de Prost, Y., Delescluse, J., Degreef, H., Theissen, U., Wallace, R., Marynissen, G., & De Doncker, P. (1999). The use of itraconazole to treat cutaneous fungal infections in children. Dermatology (Basel, Switzerland), 199(3), 248-52.
Gupta AK, et al. The Use of Itraconazole to Treat Cutaneous Fungal Infections in Children. Dermatology. 1999;199(3):248-52. PubMed PMID: 10592406.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of itraconazole to treat cutaneous fungal infections in children. AU - Gupta,A K, AU - Nolting,S, AU - de Prost,Y, AU - Delescluse,J, AU - Degreef,H, AU - Theissen,U, AU - Wallace,R, AU - Marynissen,G, AU - De Doncker,P, PY - 1999/12/11/pubmed PY - 1999/12/11/medline PY - 1999/12/11/entrez SP - 248 EP - 52 JF - Dermatology (Basel, Switzerland) JO - Dermatology VL - 199 IS - 3 N2 - BACKGROUND: Cutaneous mycoses such as tinea capitis, onychomycosis and some cases of tinea corporis/cruris, and tinea pedis/manus require oral antifungal therapy. There is relatively limited data regarding the use of the newer oral antifungal agents, e.g. itraconazole, in the treatment of these mycoses in children. OBJECTIVE: We wished to determine the efficacy and safety of itraconazole continuous therapy in the management of cutaneous fungal infections in children. METHODS: Children with cutaneous mycoses were treated with itraconazole in an open-label manner in 4 studies. For tinea capitis, the treatment regimens using itraconazole continuous therapy were: study 1, 3 mg/kg/day for 4 or 8 weeks; study 2, 5 mg/kg/day for 6 weeks, and study 3, 5 mg/kg/ day for 4 weeks. In a different trial, study 4, itraconazole continuous therapy 5 mg/kg/day was used to treat toenail onychomycosis (duration: 12 weeks), tinea corporis/ cruris (duration: 1 week) and tinea pedis/manus (duration: 2 weeks). RESULTS: The efficacy rates at follow-up 12 weeks from the start of therapy in children with tinea capitis treated using the itraconazole continuous regimen were: clinical cure (CC) and mycological cure (MC) in study 1 (n = 10, Trichophyton violaceum all patients), CC 50%, MC 86%; in study 2 (n = 35, Microsporum canis 22 patients, Trichophyton sp. 12 patients), CC 82.8%, MC 80%, and in study 3 (n = 16, M. canis 11 patients, Trichophyton sp. 5 patients), (CC 66.7%, MC 78.5%. Itraconazole was also effective in the treatment of dermatomycoses in 24 children (study 4). The CC and MC rates at the follow-up 8 weeks from the start of therapy in children with dermatomycoses and 12 months in children treated for onychomycosis were: onychomycosis (n = 1, T. rubrum), CC 100%, MC 100%; tinea corporis (n = 12, M. canis 10 patients), CC 100%, MC 90%; tinea cruris (n = 3, Trichophyton sp. 2 patients), CC 100%, MC 100%; tinea manus (n = 1, T. rubrum), CC 100%, MC 100%, and tinea pedis (n = 7, T. rubrum), CC 100%, MC 100%). Adverse effects consisted of a cutaneous eruption in 1 (1.2%) of the 85 children, with mild, transient, asymptomatic elevation of liver function tests (less than twice the upper limit of normal) in 2 (3.4%) of 58 children in whom monitoring was performed. CONCLUSIONS: Itraconazole is effective and safe in the treatment of tinea capitis and other cutaneous fungal infections in children. SN - 1018-8665 UR - https://www.unboundmedicine.com/medline/citation/10592406/The_use_of_itraconazole_to_treat_cutaneous_fungal_infections_in_children_ DB - PRIME DP - Unbound Medicine ER -