ITRACONAZOLE ORAL SOLUTION FOR THE TREATMENT OF TINEA-CAPITIS

Twenty-seven children (12 boys, 15 girls, age range 3-11 years, weight range 10-40 kg) were treated with itraconazole oral solution 10 mg/mL given as pulse therapy for tinea capitis. The dosage regimen was 3 mg /kg per day given once daily in a fasting state with each pulse lastin g 1 week. The first two pulses were separated by a 2-week off-drug per iod, and the second and third pulses had a 3-week period without drug between them. For each patient a second and third pulse were administe red if there was clinical evidence of tinea capitis at the time-point when the next pulse was due. The overall severity of tinea capitis at pretherapy was classified as mild, moderate or severe with the aetiolo gy being: Trichophyton tonsurans, 24 patients; T. violaceum, two patie nts and Microsporum canis, one patient. In 19 evaluable patients, 12 w eeks after starting therapy, the numbers of pulses of itraconazole ora l solution required to produce complete cure were, according to the se verity of disease, mild tinea capitis tone pulse: four patients; two p ulses: five), moderate disease tone pulse: two patients; two pulses: t wo; three pulses: two), and severe disease (three pulses: three patien ts). One patient with moderate severity tinea capitis was clinically c lear after three pulses of therapy but mycological examination was pos itive. Seven patients were lost to follow-up and one discontinued ther apy because of nausea. Itraconazole oral solution 3 mg/kg per day was generally well tolerated. Three children developed gastrointestinal ad verse effects which were considered to be minor or 'nuisance' effects. The data from this preliminary report need to be confirmed in a large r group of patients. It remains to be seen whether itraconazole oral s olution will become a practical alternative to the antifungal agents a vailable in a liquid preparation for the treatment of tinea capitis.