From the Guidelines
Ringworm in children should be treated with oral antifungal medications, with griseofulvin and terbinafine being the most widely used first-line treatments, as they have good evidence of efficacy 1. The choice of systemic therapy should be directed by the causative dermatophyte and/or local epidemiology, with terbinafine being more efficacious against Trichophyton species and griseofulvin more effective against Microsporum species 1. Some key points to consider when treating ringworm in children include:
- Topical therapy alone is not recommended for the treatment of tinea capitis, and oral therapy is generally indicated to achieve both clinical and mycological cure 1
- The dose of griseofulvin or terbinafine should be determined based on the child's body weight, with griseofulvin dosed at 15-20 mg/kg/day for 6-8 weeks for children under 50 kg, and terbinafine dosed at 625 mg/day for 2-4 weeks for children under 20 kg 1
- Treatment failure should be initially considered due to lack of compliance, suboptimal absorption of drug, relative insensitivity of the organism, and reinfection, and second-line therapy with itraconazole may be considered in cases of treatment failure 1
- Children receiving appropriate therapy should be allowed to attend school or nursery, and index cases due to T. tonsurans warrant screening of all family members and close contacts and treatment for those positive cases 1
From the FDA Drug Label
DOSAGE AND ADMINISTRATION ... Pediatric Use: Approximately 7.3 mg per kg of body weight per day of ultramicrosize griseofulvin is an effective dose for most pediatric patients.
On this basis, the following dosage schedule is suggested: 16 to 27 kg: 125 mg to 187.5 mg daily. Over 27 kg: 187. 5 mg to 375 mg daily Children and infants 2 years of age and younger – dosage has not been established.
The treatment for ringworm in children is griseofulvin. The dosage is based on the child's weight:
- For children weighing 16 to 27 kg, the suggested dose is 125 mg to 187.5 mg daily.
- For children weighing over 27 kg, the suggested dose is 187.5 mg to 375 mg daily. However, the dosage for children 2 years of age and younger has not been established 2.
From the Research
Treatment Options for Ringworm in Children
The treatment for ringworm in children typically involves the use of systemic anti-fungal medications. Some of the commonly used medications include:
- Griseofulvin (Grifulvin) 3
- Terbinafine (Lamisil Granules) 3, 4, 5, 6
- Itraconazole 4, 5, 6, 7
- Fluconazole 4, 5, 6, 7
Duration of Treatment
The duration of treatment for ringworm in children can vary depending on the medication used. For example:
- Griseofulvin is usually taken for 6 to 8 weeks 3
- Terbinafine is usually taken for 6 weeks 3 or 2-3 weeks 4
- Itraconazole is usually taken for 2-3 weeks 4 or 6 weeks 6
- Fluconazole is usually taken for 2-3 weeks 4 or 6 weeks 6
Efficacy of Treatment
Studies have shown that these medications are effective in treating ringworm in children. For example:
- Terbinafine and griseofulvin have similar efficacy in treating Trichophyton species infections 4, 6
- Itraconazole and griseofulvin have similar efficacy in treating Trichophyton species infections 4, 6
- Fluconazole and griseofulvin have similar efficacy in treating Trichophyton species infections 4, 6
Safety and Side Effects
The safety and side effects of these medications have also been studied. For example: