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Systemic Antifungals to Treat Onychomycosis in Children: A Systematic Review
Author(s) -
Gupta Aditya K,
Paquet Maryse
Publication year - 2012
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.12048
Subject(s) - medicine , terbinafine , itraconazole , fluconazole , griseofulvin , dermatology , cure rate , population , systemic therapy , clinical trial , antifungal , pediatrics , environmental health , cancer , breast cancer
Abstract Because of the low prevalence of onychomycosis in children, little is known about the efficacy and safety of systemic antifungals in this population. PubMed and Embase databases and the references of related publications were searched in March 2012 for clinical trials ( CT s), retrospective analyses ( RA s), and case reports ( CR s) on the use of systemic antifungals for onychomycosis in children (<18 years). Twenty‐six studies (5 CT s, 3 RA s, and 18 CR s) were published between 1976 and 2011. Most of these studies reported the use of systemic terbinafine and itraconazole for the treatment of onychomycosis in children. Therapy with systemic antifungals alone in children ages 1 to 17 years resulted in a complete cure rate of 70.8% ( n = 151), whereas combined systemic and topical antifungal therapy in one infant and 19 children age 8 and older resulted in a complete cure rate of 80.0% ( n = 20). The efficacy and safety profiles of terbinafine, itraconazole, griseofulvin, and fluconazole in children were similar to those previously reported for adults. In conclusion, based on the little information available on onychomycosis in children, systemic antifungal therapies in children are safe and cure rates are similar to the rates achieved in adults.