A randomized comparison of terbinafine vs. itraconazole for the treatment of tinea capitis- A prospective comparative study in health care centers of Southern Punjab
Treatment of tinea capitis
DOI:
https://doi.org/10.66344/jpad.v33i2.2240Abstract
Objective To evaluate the therapeutic efficacy of terbinafine in comparison with itraconazole in treatment of tinea capitis. It is pertinent to mention that tinea capitis is a pronounced disease of Southern Punjab with specific prevalence in children of Bahawalpur and surroundings in prepubertal stage, which merits a definite consideration owing to inherent implications and limitations of the disease.
Methods The Prospective comparative study conducted at health care centers of southern Punjab. It comprised 100 children aged 5-16 years, with clinically and mycologically confirmed tinea capitis by 10-30% KOH microscopy and by Sabouraud agar. The children randomized to 8 weeks’ treatment with terbinafine or 8 weeks with itraconazole. Evaluation criteria resorted to constitute inspection of random sample of patient at 0, 2, 4 and 8-week interval. Efficacy analysis based upon pooled data and photographic documentation. Outcome determined by absence of clinical signs. Safety assessment included monitoring of the frequency and severity of adverse events (AEs). Hepatic safety of itraconazole (Azole group) determined by LFTs after 4-week treatment. Data analysis conducted with SPSS and graph pads. Result presented in tabular and pictorial form.
Results There were 80 cases in both group A (Terbinafine) and group B (Itraconazole), with no tremendous contrast as far as average age, weight, pre-treatment, total sign and symptom score and number of sores. Fix was seen remarkably superior in bunch B where 70 (87.5%) cases were relieved when contrasted with bunch A where 56 (70%) cases were restored. The tolerability was likewise essentially better in bunch B, where 62 (77.5%) sufferers have either excellent or great reaction to medicate resilience as compare to bunch A where it is noticed in 42 (52.5%) sufferers.
Conclusion Itraconazole manifest noteworthy benefits with regards to cure rate, time requires for rehabilitation and acceptability which appears differently in relation to terbinafine.
References
1. E Kudago Halimat Ayodele, NC. Prevalance identification and suspectibility of antifungal in dermatophyte cause Tinea capitisin locality of north central nigeria. PMC. 2020;15i1.1:1–9.
2. Marc Zachary Dirk M Eiston. (2020). Tinea Capitis: Background, Pathophysiology, Etiology. Medscape. https://emedicine.medscape.com/article/1091351-overview
3. Vincent Jannelli. (2022, January 26). Ringworm: Causes and Risk Factors. https://www.verywellhealth.com/ringworm-causes-risk-factors-2634174
4. Will hunt. (2020). The Scalp Layers Innervation Blood Supply Teach Me Anatomy. https://teachmeanatomy.info/head/areas/scalp/?msclkid=a350b5b6cd5011ec905a96e40f6b9e9e
5. Elewski BE. Tinea capitis: a current perspective. J Am Acad Dermatol. 2020;42(1 Pt 1):1–20.
https://doi.org/10.1016/S0190-9622(00)90001-X
6. Ayanbimpe GM, Taghir H, Diya A, Wapwera S. Tinea capitis among primary school children in some parts of central Nigeria. Mycoses. 2020;51(4):336–40.
https://doi.org/10.1111/J.1439-0507.2007.01476.X
7. Fuller LC, Barton RC, Mohd Mustapa MF, Proudfoot LE, Punjabi SP, Higgins EM. British Association of Dermatologists’ guidelines for the management of tineacapitis 2014. Br J Dermatol. 2014;171(3):454–63.
https://doi.org/10.1111/BJD.13196
8. Patrick T. Mckeny, Trevor A Nessel. (2020, January). antifungal antibiotic 2020 Search.
9. Hay RJ. Tinea Capitis: Current Status. Mycopathologia. 2017;182(1):87.
https://doi.org/10.1007/S11046-016-0058-8
10. Mayser P, Nenoff P, Reinel D, Abeck D, Brasch J, Daeschlein G, Ott H, Schaller M, Zidane M. S1 guidelines: Tinea capitis. In JDDG. J German Soc Dermatol. 2020;18(2):161–79.
11. Lorch Dauk KC, Comrov E, Blumer JL, O’Riordan MA, Furman LM. Tinea capitis: Predictive value of symptoms and time to cure with griseofulvin treatment. Clin Pediatr. 2010;49(3):280–6.
https://doi.org/10.1177/0009922809338313
12. Ginter-Hanselmayer G, Smolle J, Gupta A. Itraconazole in the treatment of tineacapitis caused by Microsporum canis: Experience in a large cohort. Pediatr Dermatol. 2004;21(4):499–502.
13. McKeny PT, Nessel TA, Zito PM. (2021). Antifungal Antibiotics. StatPearls.https://www.ncbi.nlm.nih.gov/books/NBK538168/
14. Chan YC, Friedlander SF. (2005). Therapeutic options in the treatment of tinea capitis.http://Dx.Doi.Org/10.1517/14656566.5.2.219, 5(2), 219–227.
https://doi.org/10.1517/14656566.5.2.219
15. Oranje AP, Torrelo A, Kakourou T, Uksal U. Guidelines for the management of tinea capitis in children. Wiley Online Library. 2010;27(3), 226–8.
16. John AM, Schwartz RA, Janniger CK. The kerion: an angry tinea capitis. Int J Dermatol. 2018;57(1):3–9.
https://doi.org/10.1111/IJD.13423
17. Bhatia A, Kanish B, Badyal D, Kate P, Choudhary S. Efficacy of oral terbinafine versus itraconazole in treatment of dermatophytic infection of skin– A prospective, randomized comparative study. Indian J Pharmacol. 2019;51(2):116.
https://doi.org/10.4103/IJP.IJP_578_17
18. Ginter-Hanselmayer G, Seebacher C. Treatment of tinea capitis– a critical appraisal. JDDG: J Der Deutschen Dermatologischen Gesellschaft. 2011;9(2):109–14.
19. Kerlinger Lee. (2000). kerlinger and lee 2000 - Search.
20. Wiersma Jurs. (2005). wersima and jurs 2005- Search.https://www.bing.com/search?q=wersima+and+jurs+2005&qs=n&form=QBRE&sp=1&pq=wersima+and+jurs+2005&sc=221&sk=&cvid=D1A5DC7A6B534CA8B8970D99A8197B89
21. Krejicie and Morgan. (2012). Sample Size Determination Using Krejcie and Morgan Table–Kenya Projects Organization [KENPRO]. https://www.kenpro.org/samplesizedetermination-using-krejcie-and-morgan-table/
22. Adesiji, YO, Omolade BF, Aderibigbe, IA, Ogungbe Ov, Adekanle MA, Ojedele RO. Prevalence of Tinea Capitis among children in Osogbo, Nigeria, and the Associated Risk Factors. Diseases. 2019;7(1):13.
23. Gupta AK, Summerbell RC. Tinea capitis. Medical Mycol. 2000;38(4):255–87.
https://doi.org/10.1080/mmy.38.4.255.287
24. Sami Ullah Khan, Abdur rehman. (2012). Efficacy of terbinafine vs. griseofulvin in tinea capitis in the Northern areas of Pakistan. - Free OnlineLibrary.https://www.thefreelibrary.com/Efficacy+of+terbinafine+vs.+griseofulvin+in+tinea+capitis+in+the...a0298694218
25. Zainab A, Tahir R, Hanif MM. Efficacy of Terbinafine Versus Itraconazole in Treatment of Tinea Capitis. JSZMC. 2016;7(3):1027-30.
26. Friedlander, SF, Aly R, Krafchik B, Blumer J, Honig P, Stewart D, Lucky A W, Gupta K, Babel DE, Abrams B, Gourmala N, Wraith L, Paul C. Terbinafine in the treatment of Trichophyton tinea capitis: a randomized, double-blind, parallel-group, duration-finding study. Pediatr. 2002;109(4):602–7.
27. Jin Yu, Ruoyu Li, Glenn Bulmer. current topic of tinea capitis in china. Nihon Ishinkin Gakkai Zasshi. 2005;46(2):61-6.
doi: 10.3314/jjmm.46.61.
28. Deng S, Hu H, Abliz P, Wan Z, Wang A, Cheng W, Li R. A Random Comparative Study of Terbinafine versus Griseofulvin in patients with Tinea Capitis in Western China. Mycopathologia. 2011;172(5):365–72.
29. Luke Maxfield, CVPRB. (2021, August). Terbinafine - StatPearls- NCBI Bookshelf. Webpage. https://www.ncbi.nlm.nih.gov/books/NBK545218/
30. Sharma P, Bhalla M, Thami GP, Chander J. Evaluation of efficacy and safety of oral terbinafine and itraconazole combination therapy in the management of dermatophytosis. J Dermatolog Treat. 2020;31(7):749–53.
31. Gupta AK, Ginter G. Itraconazole is effective in the treatment of tinea capitis caused by Microsporum canis. Pediatr Dermatol. 2001;18(6):519–22.
32. Katsambas A, Antoniou C, Frangouli, E, Rigopoulos D, Vlachou M, Michailidis D, Stratigos J. Itraconazole in the treatment of tinea corporis and tinea cruris. Clin Experim Dermatol. 1993;18(4):322–5.
33. Piérard GE, Arrese JE, de Doncker P. Antifungal activity of itraconazole and terbinafine in human stratum corneum: a comparative study. J Am Acad Dermatol. 1995;32(3):429–35. https://doi.org/10.1016/0190-9622(95)90064-0.
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