Naslov
Optimizing the Dose if Terbinafine for the Treatment of Tinea Capitis

Autori
Skerlev, Mihael ; Friedlander, S ; Lipozenčić, Jasna ; Bretz, F ; Emady-Azar, S ; Wraith LA ; Gourmala, N ; Paul, C ; Bakshi, R

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
International Journal of Infectious Diseases / Cohen, Jonathan - Brighton : Elsevier, 2004

Skup
11th Internatinal Congress on Infectious Diseases

Mjesto i datum
Cancún, Meksiko, 05.03.2004. - 07.03.2004

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Optimization treatment; Terbinafine; Tineaa capitis; pediatric mycology

Sažetak
Introduction Tinea capitis is a dermatophyte infection of the head that commonly occurs in children. Adolescent and adult infections are uncommon, due to the fungistatic effect of sebum found in older persons1. The three main causative dermatophytes in tinea capitis are Trichophyton tonsurans, Microsporum audouinii and Microsporum canis1 Griseofulvin has been the traditional treatment for tinea capitis, but long treatment durations of up to 8 weeks are required, which may hinder complianceTerbinafine, an oral antifungal agent with fungicidal activity, is associated with high cure rates and short treatment times, and may represent a potentially effective drug in the treatment of tinea capitis. Two duration-finding trials were performed to investigate the efficacy and safety of terbinafine in tinea capitis caused by either Trichophyton spp. or Microsporum spp. Results from these studies did suggest that 4-6 weeks of therapy would be sufficient for Trichophyton and Microsporum infections, respectively. Methods Data from these two trials were pooled to develop a doseresponse model, using logistic regression analyses, to investigate the relationship between terbinafine dose and complere cure rates. Efficacy parameters were also compared between children receiving less or greater than 4.5 mg/kg of terbinafine per day. Results: 268 paediatric patients dosed by body weight recieved terbinafine 0.9 to 6.6 mg/kg /day.Complete cure rates were considerably higher in patients who received terbinafine above the median dose of 4.5 mg/kg/day .Terbinafine daily dosage was a significant predictor of mycological and clinical cure, regardless of treatment duration (p=0.03). The safety in children rreceiving doses above 4.5 mg/kg/day was similar to those receinig less. When a dose regimen of 3&#8211; 6 mg/kg/day was used, the systemic exposure in children < 40 kg was approximately 30&#8211; 60% below that observed in adults weighing 70 kg receiving a 250-mg/day daily terbinafine dose Conclusions A minimum terbinafine dose of approximately 5 mg/kg/day appeares to be required to ensure good response rate in the treatment of tinea capitis. Further trials to assess the safety and efficacy of higher doses of terbinafine are required, in order to optimize the daily dosage/treatment duration in tinea capitis.

Izvorni jezik
Engleski

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