Griseofulvin vs terbinafine for paediatric tinea capitis: When and for how long

Summary Outbreaks of tinea capitis ( TC ) can be a source of medical and economic burden for healthcare systems; Griseofulvin and terbinafine are considered to be effective first‐line treatments for TC . In order to compare the efficacy of griseofulvin and terbinafine for the treatment of TC in a paediatric population of African immigrants in the Tel Aviv area, we conducted a retrospective cohort study of all cases of TC diagnosed and treated between March 2016 and February 2018 at a dedicated TC paediatric dermatology clinic at the Tel Aviv Medical Center (which serves as a referral centre for the paediatric refugee population in the Tel Aviv metropolitan area). Epidemiologic, clinical and laboratory data were collected, and 304 patients were included. Trichophyton violaceum ( TV ), Trichophyton soudanense ( TS ) and Microsporum audouinii ( MA ) were the prominent causative organisms. Treatment with griseofulvin suspension for 12 weeks was compared with (a) griseofulvin suspension for 8 weeks and with (b) terbinafine tablets for 4 weeks. There was no statistically significant difference between the groups regarding age, sex, country of birth, ethnicity and the causative organism. Twelve weeks of griseofulvin treatment had a statistically significant better cure rate than 4 weeks of terbinafine. Treatment was significantly more effective when TC was due to infections with MA and TS as compared with TV . No statistically significant difference was observed between 12‐ and 8‐week treatment with griseofulvin.