What are the oral medications for tinea corporis (ringworm of the body) in a 7-year-old female?

From the Guidelines

For a 7-year-old female with tinea corporis, oral griseofulvin is the recommended treatment, given the lack of licensure for terbinafine in children under 12 years in the U.K., at a dose of 15-20 mg/kg per day for 6-8 weeks, as it is the only licensed treatment for tinea capitis in children in the U.K. The choice of oral therapy should be directed by the causative dermatophyte and/or local epidemiology, as stated in the British Association of Dermatologists' guidelines for the management of tinea capitis 2014 1. When considering treatment options, it is essential to note that topical therapy alone is not recommended for the treatment of tinea corporis, and oral therapy is generally indicated to achieve both clinical and mycological cure 1. Some key points to consider when treating tinea corporis in children include:

• The importance of confirming the diagnosis, ideally with a skin scraping and KOH preparation or fungal culture
• Monitoring for potential side effects, including gastrointestinal upset, headache, or rarely, liver function abnormalities
• Considering alternative oral options, such as itraconazole, although these may have different dosing regimens and potential interactions 1
• The preference for topical antifungals, like clotrimazole or terbinafine cream, for localized cases due to their efficacy and better safety profile. It is crucial to weigh the benefits and risks of each treatment option and consider the individual patient's needs and circumstances, as well as the potential for drug interactions, such as enhanced toxicity of warfarin, some anti-histamines, and antipsychotics 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).

INDICATIONS AND USAGE Griseofulvin oral suspension, USP is indicated for the treatment of dermatophyte infections of the skin not adequately treated by topical therapy, hair and nails, namely: Tinea corporis ...

For a 7-year-old female with tinea corporis, the recommended oral medication is griseofulvin. The dosage is 10 mg/kg daily, which can be individualized based on the patient's weight. Since the patient is 7 years old, her weight would likely fall into the 30 to 50 lbs or over 50 lbs category, corresponding to a daily dose of 125 mg to 250 mg or 250 mg to 500 mg, respectively, in divided doses 2. Griseofulvin is indicated for the treatment of tinea corporis, a dermatophyte infection of the skin 2.

From the Research

Oral Medications for Tinea Corporis in a 7-Year-Old Female

• The available evidence does not specifically address the treatment of tinea corporis in a 7-year-old female, but studies on tinea capitis and other forms of dermatophytosis can provide some guidance 3, 4, 5, 6, 7.
• Griseofulvin, terbinafine, itraconazole, and fluconazole are common oral antifungal medications used to treat various forms of dermatophytosis, including tinea capitis 3, 4, 5, 6, 7.
• A study on tinea capitis found that griseofulvin, terbinafine, itraconazole, and fluconazole had cure rates of 92%, 94%, 86%, and 84%, respectively 3.
• Another study on tinea imbricata found that terbinafine and griseofulvin were effective in treating the condition, while fluconazole and itraconazole were less effective 4.
• A study on tinea corporis, tinea cruris, and tinea faciei found that itraconazole was the most effective treatment, followed by fluconazole, terbinafine, and griseofulvin 6.
• The choice of medication may depend on various factors, including the extent of involvement, social situation, and availability of resources 4, 6, 7.
• It is essential to consult a healthcare professional to determine the best course of treatment for a 7-year-old female with tinea corporis, as the most effective treatment may vary depending on the specific circumstances 3, 4, 5, 6, 7.

Dosage and Administration

• The dosage and administration of oral antifungal medications can vary depending on the specific medication, age, and weight of the patient, as well as the severity of the infection 3, 4, 5, 6.
• For example, terbinafine can be administered at a dose of 62.5-250 mg per day, depending on the patient's weight 3.
• Itraconazole can be administered at a dose of 5 mg/kg per day, while fluconazole can be administered at a dose of 6 mg/kg per day 3, 6.
• Griseofulvin can be administered at a dose of 20 mg/kg per day, but its availability may be limited 3, 7.

Safety and Efficacy

• The safety and efficacy of oral antifungal medications can vary depending on the specific medication and patient population 3, 4, 5, 6, 7.
• Common adverse effects of oral antifungal medications include gastrointestinal symptoms, such as nausea and diarrhea 3, 6.
• It is essential to monitor patients for adverse effects and adjust the treatment regimen as needed 3, 4, 5, 6, 7.