Griseofulvin versus Terbinafine for pediatric Tinea Capitis: when and for how long
Jonathan Bar  Liat Samuelov  Eli Sprecher  Jacob Mashiah
First published: 25 July 2019 https://doi.org/10.1111/myc.12970
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/myc.12970
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Abstract
Background
Outbreaks of tinea capitis (TC) can be a source of medical and economic burden for health care systems. Griseofulvin and terbinafine are considered to be effective first‐line treatments for TC.

Objective
Comparing the efficacy of griseofulvin and terbinafine for the treatment of TC in a pediatric population of African immigrants in the Tel‐Aviv area.

Methods
We conducted a retrospective cohort study of all cases of TC diagnosed and treated between March 2016 and February 2018 at a dedicated TC pediatric dermatology clinic at the Tel‐Aviv Medical Center (which serves as a referral center for the pediatric refugee population in the Tel‐Aviv metropolitan area). Epidemiologic, clinical and laboratory data were collected.

Results
Data on 304 patients were collected. Trichophyton violaceum (TV), Trichophyton soudanense (TS) and Microsporum audouinii (MA) were the prominent causative organisms. Treatment with griseofulvin suspension for 12 weeks was compared to (a) griseofulvin suspension for 8 weeks, and to (b) terbinafine tablets for 4 weeks. There was no statistically significant difference between the groups regarding age, sex, country of birth, ethnicity, and the causative organism. Twelve‐weeks of griseofulvin treatment had a statistically significant better cure rate than 4 weeks of terbinafine. Treatment was significantly more effective when TC was due to infections with MA and TS as compared with TV. No statistically significant difference was observed between 12 and 8‐weeks treatment with griseofulvin.

Conclusion
Twelve‐weeks treatment with oral griseofulvin was significantly more effective than 4‐week treatment with oral terbinafine for TC caused by MA and TS.