ITRACONAZOLE VERSUS GRISEOFULVIN IN THE TREATMENT OF TINEA-CAPITIS - A DOUBLE-BLIND RANDOMIZED STUDY IN CHILDREN

Background. Tinea capitis is a fungal infection in which topical thera py is often unsuccessful. Griseofulvin has been considered to be a fir st-line therapy. Other antifungal agents are the azole derivatives. Am ong these, itraconazole was compared with griseofulvin in children in a double-blind study. Patients and Methods. Thirty-four children and o ne adult with clinical signs and symptoms of tinea capitis and with po sitive culture and microscopy for dermatophytes have been included in a double-blind comparison between itraconazole, 100 mg daily, and ultr amicronized griseofulvin, 500 mg daily. Both drugs were given for 6 co nsecutive weeks. The final evaluation was made 8 weeks after the end o f treatment to allow the hairs to regrow. Seventeen itraconazole- and 15 griseofulvin-treated patients received the complete 6-week treatmen t course. Fifteen of these 17 itraconazole patients and 14 of the 15 g riseofulvin patients had infections caused by Microsporum canis. Fifte en of 17 patients were cured by itraconazole (88%) and 15 of 17 patien ts by griseofulvin (88%). One of the patients who discontinued griseof ulvin therapy after 4 weeks was clinically and mycologically cured. Tw o of the original 17 griseofulvin patients discontinued therapy becaus e of vomiting. None of the itraconazole-treated children experienced s ide effects. Conclusions. Itraconazole is the first azole derivate tha t matches griseofulvin for the treatment of tinea capitis in children, The drug also appears to be better tolerated than griseofulvin.