Once weekly fluconazole is effective in children in the treatment of tineacapitis: a prospective, multicentre study

In an open, multicentre evaluation carried out in Brazil, Canada and South Africa we have demonstrated that fluconazole 8 mg kg(-1) once weekly is eff ective in tinea capitis caused by Trichophyton and Microsporum species, The re were 61 children, aged (mean +/- SE) 5.0 +/- 0.3 years; weight (mean +/- 5.6) 20.0 +/- 0.9 kg; 41 males, 20 females: one Asian, 57 Black, one Cauca sian and two Hispanic. The organisms were Trichophyton violaceum (33 patien ts), T. tonsurans (11) and Microsporum canis (17), The extent of tinea capi tis at pretherapy was: mild (18 patients), moderate (30) and severe (13), P atients with tinea capitis due to Trichophyton species were initially treat ed for 8 weeks with an extra 4 weeks of fluconazole if clinically indicated . All 44 patients with tinea capitis due to Trichoyhyton species were compl etely cured (clinically and mycologically) when evaluated 8 weeks after com pletion of active treatment, following 8 weeks of once weekly dosing in 35 patients and 12 weeks of once weekly dosing in nine patients. In Microsporu m canis tinea capitis, an extra 4 weeks was administered at week 12 in pati ents where it was clinically indicated at the time, Sixteen of 17 patients with M. canis tinea capitis were completely cured (clinically and mycologic ally) when evaluated 8 weeks following the end of treatment when given for 8, 12 and 16 weeks in 12, one and three patients, respectively Overall, com plete cure (clinical and mycological) occurred in 60 of 61 patients at foll ow-up 8 weeks from the end of therapy. The duration of once weekly fluconaz ole in the 60 patients was 8 weeks (47 patients), 12 weeks (10 patients) an d 16 weeks (three patients), respectively Clinical adverse effects consiste d of a mild, reversible gastrointestinal complaint in three (4.9%) of 61 ch ildren. A laboratory abnormality with elevated liver function tests was obs erved in one (5.9%) of 17 patients; this was asymptomatic, and reversible, No patient discontinued therapy, The data suggest that once weekly fluconaz ole dosing is effective, safe and associated with high compliance when used to treat tinea capitis.