Griseofulvin vs. Terbinafine in the Treatment of Tinea Capitis

AlKhalaf, Humoud Mansour; Almezani, Adnan Meteb Mohamed; Almodhaibri, Youssef Mohammad; Almusallami, Mustafa Mohamed Ali; Attiah, Jumanh Khalid; Alsahli, Abdulaziz Mohammed; Alluqmani, Maha Fahad; Saeedi, Fatimah Mohammed; Alzahrani, Ali Hassan Jaber; Al Taha, Ibrahim Abdullah; Alsharif, Somaya Khalid; ALAjwad, Fatema Hassan A.; Herzallah, Nawal Hatem

doi:10.12816/0042845

Griseofulvin vs. Terbinafine in the Treatment of Tinea Capitis

Document Type : Original Article

Authors

¹ Royal college of surgeons in Ireland

² Hail university , College of Medicine

³ Qassim University

⁴ Hera General Hospital

⁵ ibn sina national college

⁶ King Abdulaziz university

⁷ ing Abdulaziz university-Rabigh branch

⁸ Oyun City Hospital

⁹ Umm Al-Qura University

¹⁰ Imam abdulrahman bin faisal university

10.12816/0042845

Abstract

Background: Two oral antifungal agents, griseofulvin and terbinafine, have regulatory approval 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.
Purpose: The purposes 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%.
Results: 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 Microsporumspp., griseofulvin is superior (p = 0.04), whereas terbinafine is superior for Trichophyton spp. infection (p = 0.04).
Conclusion: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.

Keywords