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

From the Guidelines

For a 7-year-old female with ringworm, griseofulvin is the recommended oral medication, given its established use and licensing for this age group, despite fluconazole being an effective alternative 1. When considering oral therapy for ringworm in children, it's crucial to weigh the efficacy, safety, and licensing of available medications.

• Griseofulvin is licensed for use in children and has been shown to be effective against common causes of ringworm, such as T. violaceum, T. verrucosum, and M. canis 1.
• The dosage of griseofulvin for children is typically 10-20 mg/kg/day, and the treatment duration is usually 6-8 weeks.
• Fluconazole, although effective, is not licensed for the treatment of tinea in children under 10 years in the U.K., which may limit its use in this age group 1.
• It's also important to consider the potential for drug interactions and side effects with any oral antifungal medication, and to monitor the patient closely during treatment.
• Concurrent use of an antifungal shampoo may be recommended for scalp infections to help reduce the risk of transmission and improve treatment outcomes.
• The choice of oral medication should be based on the specific circumstances of the patient, including the severity and location of the infection, as well as any potential contraindications or interactions with other medications.

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 ... Tinea capitis

For a 7-year-old female with ringworm, the recommended oral medication is griseofulvin. The dosage is 10 mg/kg daily, which can be divided into multiple doses. Since the exact weight of the patient is not provided, the dosage cannot be calculated precisely. However, based on the given information, the daily dose for a pediatric patient over 50 lbs would be 250 mg to 500 mg daily, in divided doses 2. It is essential to note that griseofulvin is indicated for the treatment of dermatophyte infections, including Tinea corporis and Tinea capitis 2.

From the Research

Oral Medications for Ringworm in a 7-Year-Old Female

• The following oral medications have been studied for the treatment of ringworm (tinea capitis) in children:
  • Terbinafine: shown to be effective and safe in several studies, with a treatment duration of 2-6 weeks 3, 4, 5
  • Griseofulvin: has been used for decades to treat tinea capitis, with a treatment duration of 6-12 weeks 4, 5, 6
  • Itraconazole: has been shown to be effective in some studies, with a treatment duration of 2-6 weeks 4, 7
  • Fluconazole: has been shown to be effective in some studies, with a treatment duration of 2-6 weeks 4, 6, 7
• The choice of medication depends on the specific type of fungus causing the infection, as well as the child's age, weight, and medical history 4, 5, 6
• It is essential to consult a healthcare professional to determine the best course of treatment for a child with ringworm 3, 4, 5

Efficacy of Oral Medications

• Terbinafine has been shown to be effective in treating Trichophyton species infections, with a cure rate of 84.2% after 4 weeks of treatment 4
• Griseofulvin has been shown to be effective in treating Microsporum species infections, with a cure rate of 50.9% after 6-12 weeks of treatment 4
• Itraconazole and fluconazole have been shown to be effective in treating tinea capitis, but may have lower cure rates than terbinafine and griseofulvin 4, 6, 7

Safety and Adverse Events

• All of the oral medications studied have been shown to be safe and well-tolerated in children, with mild and reversible adverse events 4, 6, 7
• The frequency of adverse events attributed to the study drugs was similar for terbinafine and griseofulvin, with severe adverse events being rare 4