Tinea capitis is a relatively common superficial
fungal infection in children which requires oral antifungal
therapy. In a prospective, open study over 24 weeks,
itraconazole 5 mg/kg/day, given as capsules or as an oral
suspension for a period of 2-12 weeks, was used to treat children 1-12 years of age who had M. canis
tinea capitis. Children with mycologic evidence of M. canis
tinea capitis were entered into the study and asked to return at week 2 and then every 2 weeks thereafter until cured, with a maximum of 12 weeks of active treatment. At each visit the scalp was sampled and the material processed for light microscopy and culture examination. An extra 2 weeks of
itraconazole was prescribed if the mycology from the sample obtained on the previous visit indicated that there was still presence of the organism. Patients were administered either 2, 4, 6, 8, 10, or 12 weeks of treatment. The final follow-up visit was at 12 weeks from the cessation of
drug therapy. Laboratory blood testing was performed only if indicated by history, examination, or the development of side effects. There were 107 patients (49 boys, 58 girls; mean +/- standard error =5.6 +/- 0.2 years). Thirteen of the 107 children were given the oral
suspension. At week 12 from the
cessation of treatment there was complete (clinical and mycologic) cure in all 107 children. Increasing age of the patient correlated significantly with the length of
itraconazole capsule therapy (p=0.03). The duration of
itraconazole treatment also correlated significantly with the severity of
tinea capitis at baseline (p=0.02). Adverse effects were observed in 5 children receiving
itraconazole capsules (n=94). These were regarded as being possibly or probably due to the
drug in two children (mild transient stomach ache in one and moderate
diarrhea in one). The child with
diarrhea stopped
therapy at week 4 with complete resolution of symptoms. One of 13 children receiving the oral
suspension had mild, transient
diarrhea. There were no drop-outs in this group. Laboratory testing was not required in any patient. Compliance was very good in the patient group.
Itraconazole 5 mg/kg/day given either as a
capsule or an oral
suspension for 4-8 weeks is effective and safe in the treatment of
tinea capitis caused by M. canis.