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Griseofulvin versus terbinafine in the treatment of tinea capitis: a meta-analysis of randomized, clinical trials.
Pediatrics. 2004 Nov; 114(5):1312-5.Ped

Abstract

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.

Authors+Show Affiliations

Department of Pediatrics, Temple University Children's Medical Center, 5th Floor, 3509 N Broad St, Philadelphia, PA 19140, USA. fleeced@tuhs.temple.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis

Language

eng

PubMed ID

15520113

Citation

Fleece, David, et al. "Griseofulvin Versus Terbinafine in the Treatment of Tinea Capitis: a Meta-analysis of Randomized, Clinical Trials." Pediatrics, vol. 114, no. 5, 2004, pp. 1312-5.
Fleece D, Gaughan JP, Aronoff SC. Griseofulvin versus terbinafine in the treatment of tinea capitis: a meta-analysis of randomized, clinical trials. Pediatrics. 2004;114(5):1312-5.
Fleece, D., Gaughan, J. P., & Aronoff, S. C. (2004). Griseofulvin versus terbinafine in the treatment of tinea capitis: a meta-analysis of randomized, clinical trials. Pediatrics, 114(5), 1312-5.
Fleece D, Gaughan JP, Aronoff SC. Griseofulvin Versus Terbinafine in the Treatment of Tinea Capitis: a Meta-analysis of Randomized, Clinical Trials. Pediatrics. 2004;114(5):1312-5. PubMed PMID: 15520113.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Griseofulvin versus terbinafine in the treatment of tinea capitis: a meta-analysis of randomized, clinical trials. AU - Fleece,David, AU - Gaughan,John P, AU - Aronoff,Stephen C, PY - 2004/11/3/pubmed PY - 2005/3/11/medline PY - 2004/11/3/entrez SP - 1312 EP - 5 JF - Pediatrics JO - Pediatrics VL - 114 IS - 5 N2 - 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. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/15520113/Griseofulvin_versus_terbinafine_in_the_treatment_of_tinea_capitis:_a_meta_analysis_of_randomized_clinical_trials_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=15520113 DB - PRIME DP - Unbound Medicine ER -