From the Guidelines
Griseofulvin is indicated for the treatment of tinea capitis in pediatric patients, with a recommended dose of 15-20 mg/kg/day for patients weighing less than 50 kg and 1 g/day for patients weighing more than 50 kg, for a duration of 6-8 weeks 1. The treatment of tinea capitis in pediatric patients requires careful consideration of the causative dermatophyte and local epidemiology.
- Griseofulvin is effective against Microsporum species, but its efficacy against Trichophyton species is lower, requiring higher doses and longer treatment durations 1.
- The medication should be administered with fatty meals to enhance absorption, and common side effects include headache, nausea, and photosensitivity.
- It is essential to monitor for potential drug interactions, particularly with warfarin and oral contraceptives, and to assess liver function periodically during prolonged therapy.
- Treatment success should be confirmed with clinical improvement and, when appropriate, negative fungal cultures. Some key points to consider when treating pediatric patients with griseofulvin include:
- The importance of taking the medication with fatty food to increase absorption and improve bioavailability 1.
- The need for prolonged treatment durations, potentially up to 12-18 weeks, in cases of Trichophyton infections 1.
- The potential for variable response rates depending on the species involved, with higher response rates for Microsporum species compared to Trichophyton species 1. Overall, griseofulvin remains a viable treatment option for tinea capitis in pediatric patients, particularly for those with Microsporum infections, and its use should be guided by the most recent and highest-quality evidence available 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION ... Pediatric patients (older than 2 years): A dosage of 10 mg/kg daily is usually adequate (pediatric patients from 30 to 50 lbs, 125 mg to 250 mg daily; pediatric patients over 50 lbs, 250 mg to 500 mg daily, in divided doses).
Representative treatment periods are tinea capitis, 4 to 6 weeks; tinea corporis, 2 to 4 weeks; tinea pedis, 4 to 8 weeks; tinea unguium-depending on rate of growth-fingernails, at least 4 months; toenails, at least 6 months
The dosing for Griseofulvin in pediatric patients is 10 mg/kg daily, with the following guidelines:
- Pediatric patients from 30 to 50 lbs: 125 mg to 250 mg daily
- Pediatric patients over 50 lbs: 250 mg to 500 mg daily, in divided doses The indications for Griseofulvin in pediatric patients are for the treatment of:
- Tinea capitis: 4 to 6 weeks
- Tinea corporis: 2 to 4 weeks
- Tinea pedis: 4 to 8 weeks
- Tinea unguium: at least 4 months for fingernails, at least 6 months for toenails 2
From the Research
Dosing of Griseofulvin in Pediatric Patients
- The dosing of Griseofulvin in pediatric patients varies, but it is typically administered at a dose of 10-20 mg/kg per day 3.
- A study found that a majority (86.7%) of patients received Griseofulvin at a dose of 10-19.9 mg/kg per day, and the complete cure rate was not found to be higher among patients who received Griseofulvin at a dose of more than 20 mg/kg per day compared to those who received less than 20 mg/kg per day 3.
- Another study recommended a dose of 11 mg/kg per day of Griseofulvin for use in children 4.
- A review of the literature found that higher efficacy rates of Griseofulvin appeared to be reported with the use of higher dosages (> 18 mg/kg/d) 5.
Indications for Griseofulvin in Pediatric Patients
- Griseofulvin is considered the primary antifungal agent used to treat tinea capitis in many countries 3.
- Griseofulvin is effective in the treatment of tinea capitis caused by Trichophyton species, with a cure rate of 92.0% in one study 6.
- Griseofulvin is also effective in the treatment of tinea capitis caused by Microsporum species, with a cure rate of 88.1% in one study 5.
- Griseofulvin remains the treatment of choice for tinea capitis in children due to its efficacy, safety, and cost 7.