COMPARISON OF EFFICACY OF TABLET TERBINAFINE VERSUS SUSPENSION FLUCONAZOLE IN PEDIATRIC PATIENTS DIAGNOSED WITH TINEA CAPITIS

Abstract

OBJECTIE

To compare the efficacy of oral Terbinafine tablets and Fluconazole suspension in pediatric patients with Tinea Capitis.

METHODOLOGY

A randomized controlled trial was executed at Chandka Medical College Hospital involving 66 pediatric subjects (aged 6 months to 12 years) diagnosed with tinea capitis, characterized by a Clinical Assessment Severity Score (CASS) of 4 or greater and a body weight of 5 kg or more. Participants were randomly allocated in a 1:1 ratio to receive either weight-based oral terbinafine or fluconazole (n=33 for each treatment group). The diagnosis was established through an evaluation of clinical manifestations and KOH microscopy. The primary outcomes assessed at the 8-week mark were the rates of both complete and mycological cure. Data analysis was performed utilizing SPSS version 26, with a significance level set at p ≤ 0.05.

RESULTS

A total of 66 pediatric subjects (mean age 7.2 ± 2.7 years; 60.6% female) were randomly assigned in an equitable manner into two distinct cohorts. At the 8-week mark, the rate of complete resolution was notably higher in the terbinafine cohort (90.9%) when compared with the fluconazole cohort (66.7%) (p = 0.016). The mean Clinical Assessment Severity Score demonstrated a statistically significant enhancement in the terbinafine cohort (1.21 ± 1.43) relative to the fluconazole cohort (2.76 ± 2.42) (p = 0.002).

CONCLUSION

Oral administration of terbinafine in tablet form has been demonstrated to exhibit superior efficacy compared to fluconazole suspension for achieving a clinical resolution of tinea capitis in pediatric populations. The therapeutic effectiveness has been augmented, the duration of treatment has been reduced, and the safety profile remains advantageous, thereby establishing terbinafine as the preferred first-line therapeutic option for the management of tinea capitis in children. These results yield substantial clinical evidence that may have the potential to alter the approach to antifungal therapy in pediatric dermatophyte infections