Terbinafine: efficacy and tolerability in young children with tinea capitis due to Microsporum canis

[[[ Aims: ]]] We carried out an open, prospective, uncontrolled study to evaluate the efficacy and tolerability of terbinafine in the treatment of young children with tinea capitis due to Microsporum canis. [[[ Methods: ]]] A total of 83 healthy, immunocompetent children (age range 2-13 years) were enrolled in eight centres in Estonia, Latvia and Lithuania. Patients received oral terbinafine in dosages based on weight, 62.5 mg for those weighing 10-20 kg, 125 mg for 20-40 kg, plus application of topical 1% terbinafine cream twice daily to affected areas. Treatment lasted for 4 weeks, followed by an 8-week observation (treatment-free) period. All the subjects were assessed for efficacy and tolerability at 12 weeks. [[[ Results: ]]] Eighty-one subjects were available for assessment at 12 weeks: 32 had completely recovered, with no evidence of relapse during the observation period, and 21 showed mycological cure, but presented residual physical signs of infection. Thus the effective cure rate was 65.4% in an infection known to be more difficult to cure than other causes of tinea capitis. Terbinafine was well tolerated by these children. [[[ Conclusions: ]]] This study showed effective cure of two-thirds of 81 cases of tinea capitis caused by M. canis with a 4-week course of treatment. As one-third of the cases did not respond to treatment, we suggest using combined oral and topical treatment with terbinafine in children with tinea capitis caused by M. canis.