Efficacy of terbinafine vs. griseofulvin in tinea capitis in the Northern areas of Pakis

Abstract

Background: Since longtime griseofulvin has been in use to treat tinea capitis. However due to its decreasing efficacy, higher doses and side effects a search is going on to find out a better treatment alternative. Terbinafine is one such therapeutic option. Objectives To compare the efficacy and safety of terbinafine and griseofulvin in tinea capitis in Northern Areas of Pakistan. Patients and methods Children 3 to 12 year-old who were clinically diagnosed for tinea capitis and confirmed by potassium hydroxide microscopy were included in the study. One group was treated with terbinafine at a dose of 62.5mg for children weighing less than 20kg and 125mg for those weighing 20-40kg and other group with griseofulvin at a dose of 15mg/kg body weight. Both groups were treated for a period of 4 weeks. Visits were scheduled at baseline and week 2, 4 and 6 for evaluation of efficacy and safety monitoring. Efficacy was evaluated on the basis of clinical improvement and mycological cure. Results Terbinafine showed comparatively higher clinical cure in our patients as compared to griseofulvin at week 2 (35% vs. 22%), week 4 (50% vs. 38%) and week 6 (70% vs. 55%) [p<0.05]. Similarly, mycologic cure with terbinafine was better than griseofulvin at week 2 (30% vs. 20%), week 4 (45% vs. 35%) and week 6 (60% vs. 50%) [p<0.05]. Trichophyton tonsurans was the most common organism isolated. There were no major side effects except nausea and abdominal pain in either group. Conclusion Terbinafine is more effective than griseofulvin in treating tinea capitis in our part of the world.