What is the role of terbinafine for the treatment of tinea capitis (scalp ringworm)?

Updated: Feb 21, 2020
  • Author: Marc Zachary Handler, MD; Chief Editor: Dirk M Elston, MD  more...
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Terbinafine tablets at doses of 3-6 mg/kg/d for approximately 2-4 weeks have been used successfully for T tonsurans infections. [44, 45] An international study found that terbinafine has potent activity against dermatophyte isolates obtained from patients with tinea capitis worldwide. [46] A pediatric study found terbinafine produced significantly better cure rates than griseofulvin for tinea capitis caused by T tonsurans but not for disease caused by M canis. [47] A meta-analysis of 7 studies concluded that terbinafine was more effective for tinea capitis primarily caused by Trichophyton species, whereas griseofulvin was more effective for tinea capitis primarily caused by Microsporum species. [48] M canis is relatively resistant to terbinafine but has been treated effectively with higher doses and longer courses of therapy. 

Terbinafine acts on fungal cell membranes and is fungicidal. Adverse effects include gastrointestinal disturbances and rashes in 3-5% of cases. [49]

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