Comparison of ketoconazole and griseofulvin for treatment of tinea capitis in childhood: A preliminary study

Treatment of children with tinea capitis currently consists of griseofulvin given orally for 1 to 3 months. Ketoconazole, a newer antifungal, is effective therapy for a variety of systemic mycoses. A randomized double-blind, placebo-controlled study was undertaken to compare ketoconazole and griseofulvin treatments of children with tinea capitis. Twenty-two patients were enrolled, and 14 completed the protocol. All patients had positive initial mycologic cultures. Seven evaluated patients received each drug. The treatment groups were comparable in terms of age, weight, sex, race, duration of infection, length of therapy, and initial disease severity. Adverse reactions occurred in three ketoconazole treated patients and in none receiving griseofulvin. After 6 weeks of therapy, ketoconazole-treated patients had improved as much as griseofulvin-treated patients and were as likely to have negative mycologic cultures. Ketoconazole shows promise as an alternative to griseofulvin for treating children with tinea capitis.