Journal of the American Academy of Dermatology · 2016
Systemic antifungal therapy for tinea capitis in children: An abridged Cochrane Review.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Chen Xiaomei, Jiang Xia, Yang Ming, Bennett Cathy, González Urbà, Lin Xiufang, Hua Xia, Xue Siliang, Zhang Min
Аннотация
BACKGROUND: The comparative efficacy and safety profiles of systemic antifungal drugs for tinea capitis in children remain unclear.
OBJECTIVE: We sought to assess the effects of systemic antifungal drugs for tinea capitis in children.
METHODS: We used standard Cochrane methodological procedures.
RESULTS: We included 25 randomized controlled trials with 4449 participants. Terbinafine and griseofulvin had similar effects for children with mixed Trichophyton and Microsporum infections (risk ratio 1.08, 95% confidence interval 0.94-1.24). Terbinafine was better than griseofulvin for complete cure of T tonsurans infections (risk ratio 1.47, 95% confidence interval 1.22-1.77); griseofulvin was better than terbinafine for complete cure of infections caused solely by Microsporum species (risk ratio 0.68, 95% confidence interval 0.53-0.86). Compared with griseofulvin or terbinafine, itraconazole and fluconazole had similar effects against Trichophyton infections.
LIMITATIONS: All included studies were at unclear or high risk of bias. Lower quality evidence resulted in a lower confidence in the estimate of effect. Significant clinical heterogeneity existed across studies.
CONCLUSIONS: Griseofulvin or terbinafine are both effective; terbinafine is more effective for T tonsurans and griseofulvin for M canis infections. Itraconazole and fluconazole are alternative but not optimal choices for Trichophyton infections. Optimal regimens of antifungal agents need further studies.
OBJECTIVE: We sought to assess the effects of systemic antifungal drugs for tinea capitis in children.
METHODS: We used standard Cochrane methodological procedures.
RESULTS: We included 25 randomized controlled trials with 4449 participants. Terbinafine and griseofulvin had similar effects for children with mixed Trichophyton and Microsporum infections (risk ratio 1.08, 95% confidence interval 0.94-1.24). Terbinafine was better than griseofulvin for complete cure of T tonsurans infections (risk ratio 1.47, 95% confidence interval 1.22-1.77); griseofulvin was better than terbinafine for complete cure of infections caused solely by Microsporum species (risk ratio 0.68, 95% confidence interval 0.53-0.86). Compared with griseofulvin or terbinafine, itraconazole and fluconazole had similar effects against Trichophyton infections.
LIMITATIONS: All included studies were at unclear or high risk of bias. Lower quality evidence resulted in a lower confidence in the estimate of effect. Significant clinical heterogeneity existed across studies.
CONCLUSIONS: Griseofulvin or terbinafine are both effective; terbinafine is more effective for T tonsurans and griseofulvin for M canis infections. Itraconazole and fluconazole are alternative but not optimal choices for Trichophyton infections. Optimal regimens of antifungal agents need further studies.