Short duration treatment with terbinafine for tinea capitis caused by Trichophyton or Microsporum species

Thirty-five patients with mycologically proven scalp infections-were enroll ed in a randomized, double-blind clinical trial with oral terbinafine (dose adjusted according to patient weight) for either 1 or 2 weeks. Patients we re observed for 12 weeks; after 4 weeks, non-responders were offered an add itional 4 weeks of treatment followed by a second observation period. The c ausative organisms were Microsporum canis (n = 12), Trichophyton tonsurans (n = 12) and other Trichophyton spp, (n = 11). The Trichophyton infections were treated effectively in five of nine (56%) patients treated for 1 week and 12 of 14 (86%) patients treated for 2 weeks. Three of the non-responder s were treated for an additional 4 weeks, and one responded. In the Microsp orum group only one of seven patients treated for 1 week and none of five t reated for 2 weeks responded. However, treatment was effective in four of s ix (66%) patients treated for an additional 4 weeks. Mild to moderate adver se events: believed to be drug related occurred in four patients:in each of the two groups. Terbinafine is well tolerated, and requires 2 2 weeks of t reatment in most patients with Trichophyton scalp infections and 4 weeks or more in Microsporum scalp infections, to achieve a successful clinical and mycological response.