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Meta-analysis of randomized, controlled trials comparing particular doses of griseofulvin and terbinafine for the treatment of tinea capitis.
Pediatr Dermatol. 2013 Jan-Feb; 30(1):1-6.PD

Abstract

Two oral antifungal agents, griseofulvin and terbinafine, have regulatory approval in the United States, but it is unknown whether one has superior overall efficacy. Genus-specific differences in efficacy are believed to exist for the two agents. It is not clear at what doses and durations of treatment these differences apply. The goals of this meta-analysis were to determine whether a statistically significant difference in efficacy exists between these agents at a given dose and duration of each in tinea capitis infections overall and to determine whether a genus-specific difference in efficacy exists for these two treatments at a given dose and duration of each. We performed a literature search for clinically and methodologically similar randomized controlled trials comparing 8 weeks of griseofulvin (6.25-12.5 mg/kg/day) to 4 weeks of terbinafine (3.125-6.25 mg/kg/day) in the treatment of tinea capitis. A meta-analysis was performed using the Mantel-Haenszel method and random effects model; results were expressed as odds ratios with 95% confidence intervals. Meta-analysis of randomized controlled trials did not show a significant difference in the overall efficacy of the two drugs at the doses specified, but specific efficacy differences were observed based on the infectious species. For tinea capitis caused by Microsporum spp., griseofulvin is superior (p = 0.04), whereas terbinafine is superior for Trichophyton spp. infection (p = 0.04). Our results support species-specific differences in treatment efficacy between griseofulvin and terbinafine and provide a clinical context in which this knowledge may be applied.

Authors+Show Affiliations

University of Toronto, Toronto, Ontario, Canada. agupta@execulink.comNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

22994156

Citation

Gupta, Aditya K., and Chris Drummond-Main. "Meta-analysis of Randomized, Controlled Trials Comparing Particular Doses of Griseofulvin and Terbinafine for the Treatment of Tinea Capitis." Pediatric Dermatology, vol. 30, no. 1, 2013, pp. 1-6.
Gupta AK, Drummond-Main C. Meta-analysis of randomized, controlled trials comparing particular doses of griseofulvin and terbinafine for the treatment of tinea capitis. Pediatr Dermatol. 2013;30(1):1-6.
Gupta, A. K., & Drummond-Main, C. (2013). Meta-analysis of randomized, controlled trials comparing particular doses of griseofulvin and terbinafine for the treatment of tinea capitis. Pediatric Dermatology, 30(1), 1-6. https://doi.org/10.1111/j.1525-1470.2012.01866.x
Gupta AK, Drummond-Main C. Meta-analysis of Randomized, Controlled Trials Comparing Particular Doses of Griseofulvin and Terbinafine for the Treatment of Tinea Capitis. Pediatr Dermatol. 2013 Jan-Feb;30(1):1-6. PubMed PMID: 22994156.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Meta-analysis of randomized, controlled trials comparing particular doses of griseofulvin and terbinafine for the treatment of tinea capitis. AU - Gupta,Aditya K, AU - Drummond-Main,Chris, Y1 - 2012/09/20/ PY - 2012/9/22/entrez PY - 2012/9/22/pubmed PY - 2013/8/8/medline SP - 1 EP - 6 JF - Pediatric dermatology JO - Pediatr Dermatol VL - 30 IS - 1 N2 - Two oral antifungal agents, griseofulvin and terbinafine, have regulatory approval in the United States, but it is unknown whether one has superior overall efficacy. Genus-specific differences in efficacy are believed to exist for the two agents. It is not clear at what doses and durations of treatment these differences apply. The goals of this meta-analysis were to determine whether a statistically significant difference in efficacy exists between these agents at a given dose and duration of each in tinea capitis infections overall and to determine whether a genus-specific difference in efficacy exists for these two treatments at a given dose and duration of each. We performed a literature search for clinically and methodologically similar randomized controlled trials comparing 8 weeks of griseofulvin (6.25-12.5 mg/kg/day) to 4 weeks of terbinafine (3.125-6.25 mg/kg/day) in the treatment of tinea capitis. A meta-analysis was performed using the Mantel-Haenszel method and random effects model; results were expressed as odds ratios with 95% confidence intervals. Meta-analysis of randomized controlled trials did not show a significant difference in the overall efficacy of the two drugs at the doses specified, but specific efficacy differences were observed based on the infectious species. For tinea capitis caused by Microsporum spp., griseofulvin is superior (p = 0.04), whereas terbinafine is superior for Trichophyton spp. infection (p = 0.04). Our results support species-specific differences in treatment efficacy between griseofulvin and terbinafine and provide a clinical context in which this knowledge may be applied. SN - 1525-1470 UR - https://www.unboundmedicine.com/medline/citation/22994156/Meta_analysis_of_randomized_controlled_trials_comparing_particular_doses_of_griseofulvin_and_terbinafine_for_the_treatment_of_tinea_capitis_ L2 - https://doi.org/10.1111/j.1525-1470.2012.01866.x DB - PRIME DP - Unbound Medicine ER -